CE Panelist Name Onsite Visit Alabama FY 2017

Home , Blandford (horse), Caleb Lee Hutchinson, Charles Gibbs, Ivan Lewis, Michael DeBakey, Richard Harrison (actor)

Alabama FY 2017 CE Panelist Name Onsite Visit

ABNEY, RICHARD S ADAMS, CRAIG B ADAMS, HOMER GREGORY ADAMS, JENNIFER LYNN ADEDIJI, OLUYINKA S AGHEDO, OSASERE LAMBERT AL INSTITUTE FOR DEAF & BLI ALDAHER, AMMAR SAEM ALEXANDER, JENNY SARAH AMAN, MARIO L ANDERSON, JUSTIN ANDRADE, REGAN M APPEL, MARK ELLIOTT ARKIN, LAWRENCE M ARNOLD, MARY R Y ARYANPURE, FAWAD ASHLEY, CLAUDE THOMAS JR ASSAAD, SAMER ATKINSON, BONNIE L PHD AZRIN, RICHARD L BAALMANN, CHRISTOPHER GERAR BABB, ALAN MARK Y BABI, BASSAM MD BADEWA, ABIODUN PHILIP BANNER, SAM R BANOS, JAMES HUBERT BARNES, BRITTANY LETRELLE BARRON, WILLIAM R JR BARTEL, FRANCES K BASDEN, BRETT BASHIR, LOTFI BASS, JEREMY STUART BATES, HOLLIE LYNN CCC BEATY, STEPHEN LEE BECKER, ERIC GENE BEHAVIORAL HEALTH OF SELMA BEHAVIORAL MEDICINE BEIDLEMAN, WILLIAM B BELL, ROSA J BENNETT, THOMAS S BENNETT, WILLIAM L BENTLEY, JACK L JR Y BERNSTEIN, MICHAEL R BERRY SAWYER, KIMBERLEE CAR BETZ, ROSE M BIRMINGHAM HEALTH CARE BLACKBURN, LINDSEY PAIGE CC BLAKE, JAMES DAVIS BLAKEMAN, REBECCA SUSAN BLANDFORD, JILL MARIE BLANTON, DONALD W BLAXTON, ANGELA SEARCY BLEICH, STEVEN NEIL BLOCK, PATRICIA ANN BLOTCKY, ALAN D BLOUNT, KELLY A BLYTHE, WILLIAM R BODENHEIMER, LUCILE BONDS, TERRY LEON BOOHAKER, HIKEL ALFRED BOOTHE, JULIA LETT BORN, HENRY M BRANTLEY, WARREN G BRAY, VAUGHN G BRAY, VAUGHN GILBERT BRITT, RENE JOFFRION BRITTON, DAVID MICHAEL BROOKS, ALISSA ANTHONY CCC BROWN, KENNETH C BUCKMASTER, CHARLES VANCE BUFF, MELISSA TRAYLOR CCC BURCHFIELD, ASHLEY KEIR BURRUS, A EMBRY CCC BURTTRAM, EMILY CAROL CCC BUTTS WILKERSON, ASHLEIGH D BYNUM, JERRY M CAHABA VALLEY IMAGING CANNON, STERLING L CARDEN, WHITNEY RACHELLE CC CARPENTER, DARRELL WAYNE CARTER, LARRY D CARTER, LE HUONG CASTRO, OSCAR LOPEZ CENTER FOR SPEECH & LANGUAG CHADWICK, BRIAN STEPHEN MD CHAMPION, ERNEST J CHATTANOOGA SERVICES LLC CHIVUKULA, KRISHNA KISHORE CHOI, YOUNG H CHROMIAK, STEPHEN BLAISE CHU, RONNIE T CITRIN, BENJAMIN SOUTHER CLANCY, PRISCILLA WILSON CLARDY, JOHN W CLARK, DANIEL C CLARK, DOUGLAS C CLARK, MARIEL LAKEITHA CLAY COUNTY HOSPITAL CLEARMAN, PATSY R CCC COLEY, JUSTIN ALEXANDER COLLINS, JACQUELYN OLIVIA COLON, SYLVIA NOEMI CONFER, WILLIAM N COOSA DIAGNOSTIC CENTER CORNELIUS, KIM HUGGINS CCC COTNER, SHELBY LYNN CCC CRAWFORD, CYNTHIA L CCC CRISLER, MEGAN ELIZABETH CRUMPTON, BRET C CURRAN, EDWARD L DANIEL, LISA B DANIELS, JENNIFER BRIDGES DANNEMANN, ANDREW F DAUM, KENT MICHAEL DAVIS, ALLYNDA HEATHER CCC DAVIS, DANA K DAVIS, JOHN W DAVIS, NORMA BONNESS DAVIS, TERASA L PSYD DEERING, JOSEPH A DEFRANCISCO, ROBERT ANTHONY DEKALB REGIONAL MEDICAL CEN DEMPSEY, THOMAS R DENES, GABRIEL E DENNIS, MAURICE ERNEST JR DEPARTMENT, LABORATORY DEPARTMENT, NEURO-TESTING DEPARTMENT, RESPIRATORY CAR DEPARTMENT, X-RAY DESAI, SAURABH DEVINE, CYNTHIA LYNN DICKERSON, JASON K DILLON, MARNIE SMITH DIXON, JAMES RICHARD II DIXON, JOE W DOBBS, RICKI D DOSUNMU OGUNBI, SESI O DOWNEY, D'ANN DRAKE, BRADLEY OD DRIVER, JOSHUA J DRUMMONDS, MIRIAM REID EAGAN, DANIEL J JR EASTER SEALS CENTRAL AL EASTMAN, KIMBLE MANLEY CCC EATON, LELAND WILMOT EDDINS, CHARLES MARTIN EDGE, ROBERT E OD EICH, BRUCE S EICHLER, EDWARD MATTHEW PHD EISCHENS, GEORGE N EKAMBARAM, RAJAPPA ELIZA COFFEE MEMORIAL HOSPI ELLEDGE, E SCOTT ELLIOTT, KIMBERLY ELLIS, MARK BRIAN ENT ASSOCIATES OF AL PC EPPERSON, LARRY WAYNE ERIC KEETON, DIAGNOSTIC IMA ESLAMI, NASROLLAH ESTIS, WILLIS CLEVE LPC EUGENE, DAJUANDRA YVONNE CC FAVA, ANTHONY J FAVROT, STEPHEN R FAYETTEVILLE PSYCHOLOGICAL Y FELLERS, PAUL HOKE JR FERGUSON, BILL RYAN FEW, GARY C FISCHER, SUZANNE M FLEITAS, DONNA S FLEMING, SAMUEL E III FLOWERS HOSPITAL FONTANA, ANDRE J FOSHEE, HARRIETT B FOSTER, CARL ANDREW FOSTER, PRIMA RAO FRANKLIN, MONICA SANDERS CC FREEMAN, MICHELLE S FREIJ, WALID W FURR, STEVEN PAUL GAFFNEY, JACQUELYN CHRISANA GALLOWAY, MIREYA GAM, JOHN GANDY, ROBERT NEIL GANNON, TIMOTHY HUGH GARCIA, RUTILIO GARVER, ROBERT I JR GASTON, TYLER ELYSE GATLIN, RISHA KAHLIL MD GERMANSON, SARAH W GERSH, JONATHAN B GHOSTLEY, DAVID C PSYD GIBSON, ASHLEY ELIZABETH CC GILL, MARLIN D GILLILAND, RICHARD E GILLMAN, KORTNI GRACE GLASS, A TERESA GLASS, RACHEL CCC GODSIL, RAYMOND DEAN JR GOELZ, KEVIN TYLER GOFF, JOHN R GOLI, PRAMEELA D GOLI, VASUDEVA RAO GORDON, DAVID L GORDON, SALLY A Y GOTTHELF, HEATHER GRAY CCC GREEN, GREGORY CHAD GRESSARD, TABITHA AILLENE GRIFFIN, JAMIE TARENA GRIFFITH, HENRY RANDALL GRINDLEY, NATOYA NATALEE GUPTA, RITESH HABEL, MARTIN L HAGER, KENNON HAGER, ROY T HAKIM, HISHAM HAKIMA, MALAIKA HALL, CHARLES EDWARD JR HALL, DAVID D HAMMACK, CURRY B HAMMAD, IAD HANEY, JOHN R HARPER HOGAN, CATHY LORRAIN HARRELSON, GARY BRYDEN HARRIS, BENJAMIN HARRIS, RICHARD REX HARRISON HOLLINGER, KAREN D HARRISON, BOYDE JEROME HARRISON, HAROLD EUGENE HARRISON, JESSICA CCC HART, JERRY L HARVEY, JAMES SPOTTSWOOD HAYDEN, STEVEN MARK HAYNES, ANDRE VONTRAL HEERSINK, MARNIX E HEERSINK, SEBASTIAN BERNHAR HERNANDEZ, NATHANIEL DANIEL HERNDON, GRACIE THOMAN HILL HOSPITAL OF SUMTER COU HILL, CHARLES DAVID HILL, CHRISTI C HODO, DAVID WARD HOERCHER, MELISSA W HOLCOMB, WILLIAM E HOLLINGSWORTH, SAMUEL F HOLT, MICHAEL M HORTON, RUTH CAROLYN HOUSTON, JAMES THOMAS HOVATER, MICHAEL BRIAN HUDSON, IKEISHA NICOLE CCC HUDSON, MARY ANN CCC HUNTE, EYSTON A HUNTSVILLE HOSPITAL CENTER HUNTSVILLE IMAGING CENTER HUTTO, JUSTIN ROSS IMC DIAGNOSTIC & MEDICAL CL INTERNAL MEDICINE ASSOC PC IQBAL, FAHEEM IYER, ANAND SATHYAN IYER, SATHYAN V IZER, JAMES D JACKSON, FREDRICK J JACKSON, J M JACOBS, ANN L JACOBS, J WALTER JAMPALA, VIJAYANARAYANA RAO JANI, HIRENKUMAR JARIWALA, HASMUKH N JEFFERSON, RAY WILLIAM JENNINGS, THOMAS ALAN JETT, KATHRYN O'DONNELL CCC JIMMEH, DECONTEE MUSUBA JIN, CHANG KON JOHNSON, E ARNOLD JOHNSON, ERIC J II JOHNSON, ERNEST VAN JOHNSON, JOANN ELIZABETH JOHNSON, JOHN ALEXANDER JOHNSON, NORMAN C JOHNSTON, MICHAEL W JONES, JOHN ALLEN III JONES, JOHN TAYLOR JORDAN, RANDALL GREEN JOYNER, APRIL CCC JUNKIN, MARY REBECCA CCC KAPLAN, PHILIP L KASMIA, ABDEL HAKIM KASSAMALI, RAHIM KATTA, SADASIVA R KAYL, AMY ELIZABETH KAZI, ABDUL AHAD KEYS, KENT CALHOUN KHAN, FARRUKH SHOHAB KHAN, KHALID L KHAN, MINA SALEEM KHAN, ZAKIR NAEEM KHDAIR, IMAD ABDELHAFIZ KIDD, HUEY RANDOLPH KIDD, KELLI DIANE CCC KING, GLEN D KING, MICHELE M PHD KING, RAE KING, WILLIAM DANNY KIRK, SHANNA FLEMING KIRKLAND, KALE EDNEY KIRKLAND, KARL KIRSCHBERG, GORDON JOSEPH KLINE, ROBERT J KLINE, ROBERT SAMUEL III KNOX, SHELIA BALLEW CCC KUREMSKY, MARSHALL ALEXANDE KURTZ, ROBIN S KYLER, ASHLEY NICOLE CCC L V STABLER MEMORIAL HOSPIT LAB CORP OF AMERICA HOLDING LAB CORPORATION OF AMERICA LAB, BRENDA GOOLSBY, LAB, VASCULAR CLINICAL LABCORP LABORATORY CORPORATION OF LABORATORY CORPORATION OF A LACONSAY, KENDRA L LADIPO, ADETOKUNBO LAMBERT, AMANDA PATTERSON C LAMKIN, THOMAS G LANCASTER, JOHN WILLIAM LANDRETH, STEVEN RODNEY LARY, JOHN HOWARD JR LAW, CHERYL LAWRENCE, CHUCK WAYNE LESTER, FRANK MARTIN LEWALLEN, KATIE C LEWIS, SHERRY A LIEBERMAN, LEWIS ROBERT PHD LINDSEY, JAMES B LINDSEY, LAURA M LIU, JIA CCC LOTT, ALLISON NICOLE LOTT, JAMES H III LOWRY, ASHLEY BROOKE MADDEN, MICHAEL C MD MAIERHOFER, RICHARD A MAJURE, DORN RALPH JR MANASCO, JAMES H MASON, JOHN LAWRENCE JR MATES, AARON KYLE MATIN, FAZLE MD MATTHEWS, BELVIA W MAY, WILLIAM RUSSELL MCATEE, KATHERINE K CCC MCCLAIN, ANNY L MCCLOUD, MARK A MCCLOUD, MARK ALLEN MCCLYMONT, ALDENE ANN MARIE MCDADE, CAREY LAVON MCDONALD, WILLIAM DAVID MCFARLAND, BRIAN ROBERT MCGIVERN, BRENDA L MCKINLEY, JOANNA ANDREWS MCLENDON, JOHN PAUL MCNAMARA, CRAIG RICHARD MDSI PHYSICIAN GROUP INC Y Volume Provider MED PLUS DISABILITY INC Y Volume Provider MEADOWS, RICHARD V MEDICAL & PSYCHOLOGICAL MEKA, SARAT MENA, BLANCA LILIANA MERCADO AYERS, LISA NICOLE MILLER, PAUL CAUDILL MIZELL MEMORIAL HOSPITAL MOBILE INFIRMARY MEDICAL CT MOHAMED NEMIARY, DEINA SAYE MOHON, DAVID DUANE MOIZUDDIN, SAMIA SANA MOLLOHAN, ERNEST LEE MORAN, SILVIA GUTIERREZ MORGAN, ASHLEY DEALE MORGAN, R KEITH MORRIS, LAUREN BETH MORROW, JEFFERY A MORTON, DAVID ALAN MULL, MICHAEL B MULLADY, THOMAS F MUNOZ, GABRIELA MURPHY, RICHARD M MURRAY, DARRELL LEE MYERS, GREGORY JAY MYERS, KENTON NADELLA, RAO R NARO, ANGELENE HANKS MCD NAVARRETE, KELLY MARY NELDER, DOROTHY K NEVILLE, CYNTHIA A NEVILLE, JOHN W NICHOLS, JUNE NIX, CYNTHIA PURO NOLAN, ROBERT J NORWOOD, ESTON G III NOVELLI, PATSY G OBLENA, JOSE MACARAIG ODEH, STEVE OPITA ODI, EMMANUEL OLUSOLA OGUNTUYO, JIMMY A PADOVE, STUART J PARISH, TIMOTHY D PARKS, WILLIAM BRIAN PARVIN, NATHAN E PATEL, GHANSHYAM PEARL, RICHARD W PEDDADA, RAM RAO PEREZ, SARAH ROBERTS PERRIN, BRIAN THOMAS PETERSON, CRAIG RAYMOND PETERSON, RUSSELL DOAK PETTY, BENJAMIN MARTIN PIROFSKY, JEFFREY G PLEXICO, LAURA W CCC PLUMB, ALLISON MARGARET CCC POINTER, ANDREA WALKER CCC POOLE, JAMES H POOLE, JAMES H OD POPE, KELLIE C POPOV, DIMTCHO PORTER, CHEBON A PRESLEY, CYNTHIA CCC PRICE, RYAN CHRISTOPHER PRINCE, CATHERINE CLAYTON PROHASKA, MARK L PUGH, RACHEL M PUGH, VELDA D PULLIAM, JASON B QUALITY OF LIFE HEALTH QUIRK, PATRICK J RAHN, DAWN R CCC RAINS, JAMES C JR RAMER, DANA QUINNEY CCC RAMSEY, MICHAEL J RANDOLPH, CHRISTOPHER S REDDY, A MAHENDER REDUS, MICHAEL JAMES REYNOLDS, DAVID W REYNOLDS, RICHARD STEVEN REYNOLDS, TERRY E RICKLESS, MORTON S RIHNER, MICHAEL ANTHONY RIKARD, JULIE ANN RINN, ROGER C RIVERVIEW REGIONAL MEDICAL ROBBINS, CHARLES N ROBERTS, LINDSEY WELLS CCC ROBERTSON, ANDREA S CCC ROBIDOUX, STEPHEN J RODRIGUEZ, KIMBERLY ZLOMKE ROLAND, JENNIFER HICKS CCC ROMEO, BRUCE W RONAN, KATHLEEN PHD RONEY, TARA SMITH ROSENBAUM, MICHAEL S RUSSELL MEDICAL CENTER RUSSELL, DALLAS M MD Y SANDUSKY, PATRICIA M SANDY, JOHN THOMAS SAUCIER, K SCOTT SAXENA, SANJEEV SAXON, SAMUEL AUGUSTUS SCARBROUGH, LATANDRA C SCHMITT, LANE S CCC SCHOEL, SUZANNE GRAPHOS SCOTT, AUBREY LEE JR SEARCY, JOHN E SERVICES, CARDIOPULMONARY SETTLE, HAROLD P SHAIKH, ILYAS A SHARMA, BHAVNA SHARPE, DERON VINCIL SHARPE, THOMASINA ANDERSON SHELBY BAPTIST MEDICAL CENT SHENESEY, JESSICA WELLS SHERMAN, ALAN JAY SHUBAIR, MOHAMMED K SIDHPURA, JAGDISH R SILLIMAN, KEITH C SKELTON, LARRY O SLAVICH, IVAN LEWIS III SMITH, ERIN M SMITH, JERRI HENDRIX CCC SMITH, JOE FRANK SMITH, JUSTIN DONALD SMITH, KENNETH RANDALL SMITH, MARK P SMITH, VONCEIL CORNELIUS SNODGRASS, MICHELLE BOUCHER SONG, DAE YONG STANFORD, SUZANNE BAIR STARKEY, KENNETH RANDALL STARKEY, PAMELA MORTELLARO STEPHENS, PAUL V MS STEVENS, ERIN NICOLE STEWART, EMILY B CCC STEWART, SCOTT J STILES, WARREN A STORJOHANN, ROBERT A STOUGH, CAROLINE KIMBROUGH STRASSBURG, MARK FREDERICK STROUP, KIMBERLY WATKINS STUDSTILL, SHERRI LYNETTE STURRIDGE, KIRK ALEXANDER STUTTS, W LEE SULLINS, STEVE L SUMMERLIN, ROBERT G PHD SUON, VANNARITH S SYED, ASHRAF AHSAN TALERICO, CHRISTINA MARIE TAMBURIN, JEFFREY M TANG, LONI R TARABEIN, RASSAN M TAYLOR, BRANDON ADRIAN TEMPLE, JAMES P TENBRUNSEL, THOMAS W TENCHAVEZ, ALVIN V THOMAS, BRIAN PSYD THOMAS, CARLA MD THORNTON, PEGGY B TOBING RUIZ, BETH H TOCCI, NINA E PHD TODOROV, ALEXANDRE B TRI STATE OCCUPATIONAL MED. TUBRE, KRISTIN RENEE TUCKER, KELLY ALLEN CCC TURNER, JOSEPH RYAN UKACHI, CHIMA AUSTIN UNIVERSITY OF AL BIRMINGHAM UNIVERSITY OF SOUTH AL USA SPEECH & HEARING CENTER VAKHARIA, BHARAT K VANSICKLE, KAYCIA LYNNE VAPHIADES, MICHAEL S VARDEN, KEVIN KEITH VAUGHAN, WALLACE C JR VEREN, AUDREY CLARK CCC VESTER, ALPHONZA VESTER, TERRY YVONNE OLLENWEIDER, GLEN PAUL VORA, AMIT V WADLEY CORNERSTONE CLINIC WALKER, ALLISON ELIZABETH WALKER, EDWARD EARL WALKER, PAUL LANCE WALKUP, ROBERT H JR WALTZ, SHARON DIANNE Y Volume Provider WANG, CHUNLEI WARREN, FERNELLE LEKOYNE WARREN, PAULA PROVINCE WATKINS, PAUL ACKER MACPHER WEBER, ELLEN STAMMER WEBSTER, DESIREE WEEKS, HOPE MCARN WEIHING, MORGAN CCC WELCH, KATHY CCC WELLS, BARBARA K WHATLEY, WESLEY STILES WHEELER, KRISTOPHER SCOTT WHITCHARD, KIMBERLY A WHITE SPUNNER, SUANNE WHITE, ZANETHA LASHAY CCC WILLIAMS, ASHLEY R WILLIAMS, LUCILE T WILLIAMS, MICHAEL SETH WILLIAMS, TED ALEXANDER WILLIS, LAURA B CCC WRIGHT, CATHY L CCC WRIGHT, CATHY LYNN CCC WRIGHTS, SHARIENNE WADE WYATT, MASSI HUGH YAGER, JOHN G YANCEY, LAUREN WEST YARBROUGH, LINDSAY ANNE YONGKUMA, CALEB YONGKUMA YOUNG KING, MELISSA RENEE YOUNG, CAROLYN ELAINE CCC YOUNG, FRANK C III ZARZAUR, JOSEPH A ZYLLA JONES, ELIZABETH CCC Active Alaska DDS CE Providers Name Title Speciality Location License Exp Date* Start Year Top 5/Onsite Done Active Alaska DDS CE Providers Andreassen, Ray DO Family Practice Delta Junction 12/31/2018 2017 Batchelder, Darlene SLP Speech/Language Anchorage 9/30/2018 pre-2000 Bigelow, Sarah PA-C General Practice Anchorage 12/31/2018 2012 Yes/IPMS Bock, Jacqueline PhD Psychology Kenai 6/30/2019 2005 Breffeilh, Robert MD Ophthalmologist Juneau 12/31/2018 2001 Campbell, William MD Psychiatry Anchorage 12/31/2018 1981 Christensen, Ron MD General Practice Anchorage 12/31/2018 1990? Yes/IPMS Coon, Larry OPT Optometry Fairbanks 12/13/2018 2002 Craig, Paul PhD Neuropsychology Anchorage 6/30/2019 pre-2000 Downs, Mary MD Neurologist Anchorage 12/31/2018 2014 Downs, Wayne MD Neurologist Anchorage 12/31/2018 2014 Foelsch, James MD Neurology Fairbanks 12/31/2018 pre-2000 Geeseman, Deborah MD Psychiatry Anchorage 12/31/2018 2016 Gevaert, Michel MD Physical Medicine Anchorage 12/31/2018 2016 Gonzales, Dan PhD Psychology Anchorage 6/30/2019 2011 Yes Gritzka, Thomas MD Orthopedics Anchorage 12/31/2018 2000 Hammond, Thomas MD Otolaryngology Fairbanks 12/31/2018 2010 Hansen, Michael PA-C General Practice Anchorage 12/31/2018 2012 Yes/IPMS Hansen, Peter MD Family Practice Kenai 12/31/2018 1990? Hill, Lani ANP General Practice Ketchikan 11/30/2018 2013 Hunter, Robert MD General Practice Sitka 12/31/2018 2001 Jensen, Welby MD Psychiatry Kodiak 12/31/2018 pre-2000 Johnston, Shawn MD Physical Medicine Anchorage 12/31/2018 2016 Jones, Laura PhD Psychology Anchorage 6/30/2019 pre-2000 Kesselring, John PhD Psychology Juneau 6/30/2019 2003 Kim, Sam MD Otolaryngology Fairbanks 12/31/2018 2009 Klimow, Susan MD Physical Medicine Anchorage 12/31/2018 pre-2000 Langdon, Mary MD Psychiatry ANC/Homer 12/31/2018 2016 Levine, Larry MD Physical Medicine Anchorage 12/31/2018 2016 Lovering, Nancy SLP Speech/Language Anchorage 9/30/2018 2002 Marbarger, Peter MD Internal Medicine Anchorage 12/31/2018 pre-2000 Martin, Karen AuD Audiology Soldotna 9/30/2018 2001 Martino, Ronald MD Psychiatry/Neurology Fairbanks 12/31/2018 pre-2000 Meinhardt, Ernest MD General Practice Anchorage 12/31/2018 1990? Yes/IPMS Morgan, Charles PhD Psychology Sitka 6/30/2019 pre-2000 Olson, Erik MD Physcial Medicine Anchorage 12/31/2018 2016 Onorato, Janice MD Neurology Fairbanks 12/31/2018 pre-2000 Ragle, William MD Internal Medicine Anchorage 12/31/2018 pre-2000 Rose, Michael PhD Psychology Anchorage 6/30/2019 1990? Yes Russell, Heather PhD Psychology Anchorage 6/30/2019 2008 Sexton, Joyce AuD Audiologist Anchorage 9/30/2018 2001 Shank, John OPT Optometry Kodiak 12/31/2018 2010 Smith, Douglas MD Psychiatry Anchorage/Juneau 12/31/2018 2007 Smith, Kyle OD Optometry Anchorage 12/31/2018 2016 Totten, Mary MD Otolaryngology Anchorage 12/31/2018 2015 Turner, Paul PhD Psychology Kenai 6/30/2019 pre-2000 Thurston-Hicks, A. MD Psychiatry Fairbanks 12/31/2018 2012 Ver Hoef, Anne SLP Speech/Language Anchorage 9/30/2018 2006 Voigt, Jessica AuD Audiologist Anchorage 9/30/2018 2000 Wendt, Nina PhD Psychology Fairbanks 6/30/2019 2010 White, Rebecca MD Family Practice Palmer 12/31/2018 2016 Winn, Danelle PhD Psychology Anchorage 6/30/2019 2002 Yes Wiszinckas, Evelyn PhD Psychology Kodiak 6/30/2019 2005

*At the time of License Expiration Date, the State Licensing website is checked for a license renewal and new expiration date. Concurrently, the SAM website is also queried. Former Panelists

Preecs, Gordon Zuelsdorf, Dean Arizona DDS Providers: FFY 2017 Page 1 of 4

Attachment 2: CE Magement Oversight Report; AZ-FFY 2017 Key Providers Onsite Reviews (Per POMS: DI (Per POMS: DI 39545.100) 39545.500)

$$= ≧$150k TOTAL ARIZONA DDS CE PROVIDERS; FFY 2017 = 181 Phoenix Providers = 141 PP= Primary Practice Tucson Providers = 40 T5= Top 5

VENDOR NAME PHOENIX TUCSON (S03) (V16) ADRIANA WEYER PH.D. X ADVANCED EAR NOSE AND THROAT X ALEXANDER PIATKA PH.D. X ALICIA NIETO JACOBS X ALL ABOUT SPEECH X ALYSHA TEED PH.D. X AMANDA NELLIS PH.D. LPC X AMY D'AMBROSIO PSY.D. (DDSA) X ANDREW C. JONES, PH.D. X 06/14/17; 06/22/17 ANGEL GOMEZ M.D. X 08/03/17 ANNE HARRIS PH.D. X ARIZONA CENTER FOR CHEST DISEASE X ARIZONA PSYCHOLOGICAL ASSESSMENT, INC X $$ PP T5 ARMANDO BENCOMO PH.D X $$ T5 06/14/17 ASHVIN K. SHAH, MD PC X 06/14/17 ASU SPEECH AND HEARING CLINIC X AZ TECH RADIOLOGY X BANNER CASA GRANDE MEDICAL CENTER X BANNER HEALTH PAGE HOSPITAL X BARNET DULANEY PERKINS EYE CENTER X 06/22/17 BEST MEDICAL GROUP, LLC X BEVERLY JO YOCHES PSY.D. X BRENT GEARY PH.D. X BRIAN BRIGGS M.D. X CANYON VISTA MEDICAL CENTER X CARTER IMAGING CENTER X CATHOLIC COMMUNITY SERVICES OF SOUTHERN ARIZONA X CELIA DRAKE PH.D. X CHANGE POINTS COACHING & CONSULTING, LLC X CHARLES HOUSE PHD X CHARLES S. GANNON, MD X CHRISTINA M VASQUEZ, PH.D. X 03/09/17; 04/24/17 CHRISTINE TETZLOFF, PH.D X 08/17/2017 COBRE VALLEY COMMUNITY HOSPITAL X COMPUDIAGNOSTICS INC X CONCENTRA URGENT CARE X CONNIE PYBURN PH.D. X COOPER LOPEZ AND ASSOCIATES, PLLC X 06/22/17 DANIEL CHATEL PH.D. X DAVID BEIL-ADASKIN, PSY.D X 06/14/17; 06/22/17 Arizona DDS Providers: FFY 2017 Page 2 of 4

VENDOR NAME PHOENIX TUCSON Key Providers Onsite Reviews (S03) (V16) DAVID JARMON PHD X DAVID MCGAREY, MD/THOMAS JOHN X DESERT VALLEY RADIOLOGY X DEVELOPMENTAL & EDUCATIONAL PSYCHOLOGICAL SERVICES X DIAGNOSTIC AND INTERVENTION SVCS, PC X EAST VALLEY DIAGNOSTIC IMAGING X EAT TALK AND PLAY THERAPY LLC X ERIN SOUTH PSY.D. X FBH PSYCHOLOGICAL SERVICES PLLC X FLAGSTAFF MEDICAL CENTER X FOUR CORNERS RADIOLOGY X FRANCISCO SANCHEZ, PH.D X 03/09/17 FRED WIGGINS, PH.D X G & K MEDICAL ASSOCIATES PC X GARY REYES PH.D. X GEORGE DELONG, PH.D. X 08/18/2017 GLENN MARKS, PH.D X GREGORY HUNTER MD X $$ PP T5 08/18/2017 GRETCHEN SCHEURICH SLP X GWENDOLYN W. JOHNSON, PH.D. X H2 CHANGE, LLC X 06/05/17 HAVASU REGIONAL MEDICAL CENTER X HEATHER NASH PH.D. X IMAGING CENTER @ YUMA REGIONAL MEDICAL CENTER X INSIGHT IMAGING CENTER X INTERMOUNTAIN HEALTHCARE X JACQUELINE KAYE MA CCC-SLP X 06/14/17 JACQUELINE WORSLEY PSY.D. X JAMES ARMSTRONG, PH.D. (YUMA) X 06/14/17 JAMES HUDDLESTON PH.D. X JASON FRIZZELL PH.D. PLLC X JEFFREY MOORE, AU.D. X JERI B. HASSMAN, MD X $$ T5 01/05/17; 06/14/17 JEROME ROTHBAUM, M.D. X PP T5 03/09/17; 04/13/17 JESSICA LECLERC PSY.D. X JILL M. PLEVELL, PH.D. X JOHN MATHER PH.D. X JONATHON GROSS, M.D. X JONI LONG SLP X JOSE ABREU PH.D. X $$ PP T5 02/17/17 JOSEPH BENACH, PSY.D X 01/05/17; 06/14/17; 06/22/17 JOSEPH BURRIDGE (JEA ASSESSMENTS) X JUSTIN JOHNSEN MD X KARI COELHO PSY,D X KARIN AHLSTRAND, PH.D. X KARLAYE RAFINDADI, PH.D X 06/05/17 Arizona DDS Providers: FFY 2017 Page 3 of 4

VENDOR NAME PHOENIX TUCSON Key Providers Onsite Reviews (S03) (V16) KATHRYN L BROWN DO X KATHY HANSEN INTERPRETING & TRANSLATION X KEITH CUNNINGHAM MD X $$ PP T5 03/14/17 KELLY JENKINS SLP X KENT COX MD X KIDS HEALTH AND HARMONY X KIM JOHNSON PH.D. X KRASNER MEDICAL CONSULTANTS, LLC X 06/14/17 LA PAZ REGIONAL HOSPITAL X LABCORP X LANGUAGE CONNECTION X LITTLE COLORADO MEDICAL CENTE X LITTLEFIELD PSYCHOLOGICAL SERVICES, INC X LYNN L. FLOWERS, PH.D. (YUMA) X 06/14/17 MACHELLE MARTINEZ, PH.D. X T5 07/06/17 MAHSA SALEK, SLP X MARICOPA EAR NOSE AND THROAT, PC X MARYANNE BELTON, PSY.D. X 08/21/17 MATTHEW HELLER, DO/WARREN HELLER, MD X MDSI X $$ PP T5 MEDICAL DIAGNOSTIC IMAGING GROUP X MEDICAL DIAGNOSTIC SERVICES X MEDICO X $$ PP T5 10/08/16, 06/06/17 MICHAEL CHRISTIANSEN, PH.D. X MICHAEL P. MOORE, PH.D. X 06/22/17 MICHELE SMITH, SLP X MINETTE DOSS ED.D X MOHAVE DESERT RADIOLOGY PLC X MOUNTAIN WEST MEDICAL IMAGING X MT GRAHAM COMMUNITY HOSPITAL X NANCY HOMCO MS X NEIL HOROWITZ PH.D. X NEIL STAFFORD PSY.D. X NICOLE TAYLOR PH.D. X NOELLE ROHEN, PH.D. X PP T5 01/05/17; 06/14/17 NORTHERN ARIZONA CARDIOPULMONARY X NORTHERN ARIZONA PULMONARY SPECIALISTS X NORTHERN ARIZONA RADIOLOGY, PC X NORTHERN ARIZONA UNIVERSITY X NORTHLAND-RURAL THERAPY ASSOC X OASIS URGENT CARE X 06/15/17 OLYMPUS HEALTH SERVICES LLC X PALMER FAMILY MEDICINE X T5 06/22/17; 08/21/17 PATRICIA FALCON, PSY.D X PATRICIA ROSE ED.D X PRECISION EYECARE INC. X PRESCOTT MEDICAL IMAGING, LLC X Arizona DDS Providers: FFY 2017 Page 4 of 4

VENDOR NAME PHOENIX TUCSON Key Providers Onsite Reviews (S03) (V16) PRIORITY MEDICAL CENTER INC X PROFESSIONAL COURT INTERPRETING & TRANSLATION X PSYCHOLOGICAL ASSESSMENT ASSOCIATES OF AZ X 10/08/16, 12/15/16, $$ PP T5 12/17/16 RADIOLOGY LIMITED X REHOBOTH MCKINLEY CHRISTIAN HOSPITAL X RICHENS EYE CENTER X RICK WEBSTER, PSY.D. X RISA NEWELL PH.D. X RIVERVIEW VISION CENTER X ROBIN POTTER PSY.D. X RONIC PSYCHOLOGICAL SERVICES X $$ T5 06/24/17 RONN LAVIT PH.D X SAN JUAN REGIONAL MEDICAL CEN X SANDRA KNIGHT PSY.D. X SANTA CRUZ RADIOLOGY X SCOTTSDALE MEDICAL IMAGING X SENTIENCE PSYCHOLOGICAL SVCS X 09/21/17 SHANNON MCGOVERN, PH.D. X SHANNON TROMP PH.D. (PRESCOTT X SHARON STEINGARD DO X SHELLY WOODWARD PH.D X SHERRI GALLAGHER PH.D X SLOAN R. KING, PH.D. X 06/14/17 SONIA ACKERMAN M.ED., CCC-SP. X SONIA PERALA, PH.D. X SONORA QUEST LAB X SOUTHERN ARIZONA RAD ASSOCIAT X ST GEORGE RADIOLOGY X ST JOSEPHS HOSPITAL X STEPHEN GILL PH.D (PRESCOTT) X STEVEN PATRICK PH.D./SUSAN PATRICK PSY.D. X SUMMIT HEALTHCARE REGIONAL MEDICAL CTR X TERRY COLYAR MS CCC X TRI STATE AUDIOLOGY X TRILOGY PSYCHOLOGICAL SERVICES X TUCSON EAR, NOSE AND THROAT X TUCSON MEDICAL CENTER RESPIRATORY CARE X UNITED INTERPRETING SERVICES X UNIVERSITY OF ARIZONA HEARING CLINIC X 05/24/17 VALLEY CENTER OF THE DEAF X VALLEY EAR NOSE & THROAT X VALLEY RADIOLOGISTS, LTD X WAYNE R GENERAL, PH.D. X WESTERN ARIZONA REGIONAL MEDICAL CTR X WHITE MOUNTAIN RADIOLOGY X YAVAPAI REGIONAL MEDICAL HOSP X YESENIA SPALETA, SLP X YUMA REGIONAL MEDICAL CENTER X Arkansas FY 2017 All Vendor Locations With CEs in FY 2017 Name Vendor # City State WHITE RIVER MEDICAL CENTER (b) (6) BATESVILLE AR OUACHITA COUNTY MEDICAL CENTER CAMDEN AR ASHLEY COUNTY MEDICAL CENTER CROSSETT AR DEWITT HOSPITAL & NURSING HOME, INC. DEWITT AR CARLTON NEWSOME, M.D. EL DORADO AR EVERETT C. MOULTON, III, M.D. FORT SMITH AR G. EDWARD BRYANT, JR., M.D. HELENA AR NATIONAL PARK MEDICAL CTR. HOT SPRINGS AR ST. BERNARD'S MEDICAL CENTER JONESBORO AR DAVID MARK LEWIS, M.D. JONESBORO AR ANTHONY D. JOHNSON, M.D. LITTLE ROCK AR CHI ST. VINCENT INFIRMARY LITTLE ROCK AR MAGNOLIA REGIONAL MEDICAL CENTER MAGNOLIA AR BAXTER REGIONAL MEDICAL CENTER MOUNTAIN HOME AR HOWARD MEMORIAL HOSPITAL NASHVILLE AR MUFIZ A. CHAUHAN, M.D. BIRMINGHAM AL VERN ANN SHOTTS, M.D. PARAGOULD AR JEFFERSON REGIONAL MEDICAL CENTER PINE BLUFF AR TED HONGHIRAN, M.D. RUSSELLVILLE AR WILLIAM H. NEVINS, M.D. SEARCY AR DBA NORTHWEST MEDICAL CENTER SPRINGDALE AR LAWRENCE MEMORIAL HOSPITAL WALNUT RIDGE AR EDGAR S. FERGUSON, M.D. WEST MEMPHIS AR MEMPHIS NEUROLOGY MEMPHIS TN HOT SPRINGS RADIOLOGY SERVICES HOT SPRINGS AR ASSOCIATED RADIOLOGISTS, LTD JONESBORO AR PATRICIA L. GRIFFEN, PH.D. LITTLE ROCK AR EAST ARKANSAS CHILDREN'S CLINIC FORREST CITY AR RADIOLOGY ASSOCIATES, PA LITTLE ROCK AR MILLARD HENRY CLINIC OF RUSSELLVILLE RUSSELLVILLE AR MOUNTAIN HOME RADIOLOGY CONS. MOUNTAIN HOME AR PINE BLUFF RADIOLOGISTS, LTD. PINE BLUFF AR DOUGLAS W. MARX, M.D., P.A. MOUNTAIN HOME AR CHARLES M. SPELLMANN, PH.D. MONTICELLO AR CHARLES M. SPELLMANN, PH.D. HELENA AR CHARLES M. SPELLMANN, PH.D. FORREST CITY AR CHARLES M. SPELLMANN, PH.D. BRINKLEY AR CHARLES M. SPELLMANN, PH.D PINE BLUFF AR ROBERT L. SPRAY, JR., PH.D. FORT SMITH AR NANCY J. TOOMBS, ED.D. CONWAY AR ARKANSAS PSYCHOLOGICAL SERVICES (b) (6) LITTLE ROCK AR DIAGNOSTIC ULTRASOUND MEMPHIS TN RAFAEL F. OTERO, PH.D. TEXARKANA TX SUSAN STANLEY, MS, CCC-SLP TEXARKANA TX VAN HOANG, M.D. FORT SMITH AR ATIYA N. WAHEED, M.D., P.A. PINE BLUFF AR WILLIAM B. LITTLE, PH.D. MEMPHIS TN JOHN FLOWERS, SR., M.D. PINE BLUFF AR JOHN B. JIU, M.D. JONESBORO AR UCA SPEECH & HEARING CENTER CONWAY AR DONNA M. EDGMON, MA, CCC-SLP FAYETTEVILLE AR EDWARD C. KLEITSCH, PH.D. SHERWOOD AR CARL E. FLINN, M.D., P.C. MEMPHIS TN SURGICAL CLINIC VASCULAR LAB LITTLE ROCK AR MELANIE SMITH, M.D. NORTH LITTLE ROCK AR KENNETH M. KILGORE, M.D. HARRISON AR KENNETH M. KILGORE, M.D. MOUNTAIN HOME AR SHAILESH C. VORA, M. D. EL DORADO AR SIDNEY H. KRIGER, M.D. MEMPHIS TN DAVID LEE WEBBER, D.O. HELENA AR ADAM STIBICH, M.D. BRYANT AR LINDA DYER HARTSFIELD, ED.D. LITTLE ROCK AR R. SAM BOYD, PH.D. CONWAY AR LITTLE RED SKIN & EYE CLINIC HEBER SPRINGS AR GLENDA G. HANSON, CCC-SLP MONTICELLO AR NILA RENEE BOOTH, MSP-CCC COTTER AR KENNETH HOBBY, PH.D. SEARCY AR KENNETH HOBBY, PH.D. NEWPORT AR WILLIAM LADELL DOUGLAS, M.D. HOPE AR DON OTT, PSY.D. RUSSELLVILLE AR GEORGE M. DEROECK, PSY.D. LITTLE ROCK AR MICHAEL R. WESTBROOK, M.D. OZARK AR THE EYE GROUP, LLC FORT SMITH AR G. EDWARD BRYANT, JR., M.D. WEST MEMPHIS AR BRENDA H. NOBLES, PH.D. BENTON AR KENNETH B. ROBINSON, MS, CONSULTING SERVICES WHITE HALL AR KENNETH B. ROBINSON, MS, CONSULTING SERVICES MONTICELLO AR KENNETH B. ROBINSON, MS, CONSULTING SERVICES HELENA AR KENNETH B. ROBINSON, MS, CONSULTING SERVICES BRINKLEY AR ALICE A. ABBOTT, PSY.D. EL DORADO AR RICHARD D. BACK, PH.D. FAYETTEVILLE AR KENNETH B. JONES, PH.D. WEST MEMPHIS AR KENNETH B. JONES, PH.D. (b) (6) MARKED TREE AR KENNETH B. JONES, PH.D. FORREST CITY AR KENNETH B. JONES, PH.D. HELENA AR HARRIS HEARING CENTER, INC. BATESVILLE AR CHARLES H. MALLORY, PH.D. LITTLE ROCK AR BENJAMIN ASAFO-BOAKYE, M.D. BLYTHEVILLE AR PATRICIA WALZ, PH.D. FORT SMITH AR CARA K. DEROECK, LPE LITTLE ROCK AR MERCY HOSPITAL - BERRYVILLE BERRYVILLE AR SHABBIR DHARAMSEY, M.D. PINE BLUFF AR A. JACK SOMERS, JR., M.D. LITTLE ROCK AR R. SAM BOYD, PH.D. LITTLE ROCK AR W. CHARLES NICHOLS, PSY.D. HARRISON AR LEE ANN BROSH, CCC-SLP LITTLE ROCK AR COLLEEN C. ALLEN, CCC-SLP PEARCY AR UNITY HEALTH HARRIS MEDICAL CENTER NEWPORT AR NORTH ARKANSAS REGIONAL MEDICAL CENTER HARRISON AR A+ HEARING SERVICE LITTLE ROCK AR MEMPHIS HEARING AID AND AUD. SVCS. MARION AR MERCY CLINIC RADIOLOGY HARRISON AR BENNETT L. RUDORFER, M.D., FACC WEST MEMPHIS AR CHRISTOPHER P. LOWRY, MA, CCC-A EL DORADO AR J. A. ALEMPARTE, M.D. FORT SMITH AR RONALD L. KANTOLA, M.D. FORT SMITH AR KELLEY RENEE LINTON, AUD FORT SMITH AR LORI R. MALONE, CCC-SLP JONESBORO AR L. JANE BARRETT, CCC-SLP CLARKSVILLE AR GLEN M. ADAMS, PSY.D. SEARCY AR JANA RENE FOLEY, CCC-SLP LITTLE ROCK AR JON HENDRICKSON, M.D. FORT SMITH AR SUDHIR KUMAR, M.D. FORREST CITY AR LESLEA ANN CLARK, MS, CCC-SLP CONWAY AR ANN MARIE PRATHER, PH.D. LITTLE ROCK AR CLOPTON CLINIC OF JONESBORO, INC. JONESBORO AR JADA HANDWORK, MCD, CCC-SLP JONESBORO AR BERNARD G. CROWELL, M.D. LITTLE ROCK AR NEUROLOGY CLINIC OF SOUTH ARKANSAS WHITE HALL AR JENNIFER J. LACOMFORA, MS, CCC-SLP HOT SPRINGS AR KEITH NORWOOD, P.E. CONWAY AR MICHAEL A. MCGHEE, M.D. BENTON AR CHRISTINE GOULET, AUD FORT SMITH AR SPEECH PATHOLOGY SERVICES, PLLC TEXARKANA TX KEITH NORWOOD, P.E. (b) (6) NORTH LITTLE ROCK AR CREDONNA L. MILLER, AU.D. HOT SPRINGS VILLAGE AR KEITH NORWOOD, P.E. JONESBORO AR SHARON BETH GOODE, MSP, CCC-SLP MARION AR SHARON BETH GOODE, MSP, CCC-SLP MARION AR CHRISTIE BETH COUCH, CCC-SLP POCAHONTAS AR CHRISTOPHER L. JOHN, M. D. LITTLE ROCK AR WEIGHT WATCHERS OF GREATER AR SEARCY AR WEIGHT WATCHERS OF GREATER AR RUSSELLVILLE AR ARKLATEX ASSESSMENTS TEXARKANA TX CHAMBERS MEMORIAL HOSPITAL DANVILLE AR D'ORSAY D. BRYANT, III, M.D. EL DORADO AR NANCY J. TOOMBS, ED.D. WHITE HALL AR NANCY J. TOOMBS, ED.D. REDFIELD AR DIANE ESTES, CCC-SLP WHITE HALL AR NANCY J. TOOMBS, ED.D. N. LITTLE ROCK AR SHANNON FRYE, MCD, CCC-SLP BLYTHEVILLE AR JERRY GRANT, M.D. EL DORADO AR SHANNON H. BROWNFIELD, M.D. HARRISON AR WEIGHT WATCHERS OF GREATER AR FAYETTEVILLE AR THOMAS O. BAILEY, M.D. HELENA AR JASON FULLER, CCC-SLP SEARCY AR FAYETTEVILLE DIAGNOSTIC CLINIC FAYETTEVILLE AR BLAKE NORTON GEREN, M.D. FORT SMITH AR RONALD ALAN BURKS, O.D. SHERWOOD AR TIMOTHY OVERLOCK, M.D. TEXARKANA TX GEM (GERALDENE E.) MOORE, PH.D. LITTLE ROCK AR SHANNON TANNER SEARCY AR JAMES A. SIMPSON, M.D. SEARCY AR STEPHEN P. NICHOLS, PH.D. FAYETTEVILLE AR DEBORAH LYNN ANDRADE SILOAM SPRINGS AR DAVID LEE WEBBER, D.O. FORREST CITY AR INGE RENATE CARTER, M.D. LITTLE ROCK AR WILLIAM KENNETH CLARY CLARKSVILLE AR ANDREA SHEA STILLWELL, PSY.D. BENTON AR KEITH NORWOOD, P.E. PRESCOTT AR KEITH NORWOOD, P.E. FAYETTEVILLE AR KEITH NORWOOD, P.E. BRYANT AR KEITH NORWOOD, P.E. MALVERN AR LINDA RUNION JOSEF, PH.D. HOT SPRINGS AR YVONNE H. OSBORNE, PH.D. MEMPHIS TN ETHAN J. WRIGHT, M.D. MOUNTAIN HOME AR ETHAN J. WRIGHT, M.D. (b) (6) HARRISON AR BRITTANY B. BOYETTE, O.D. SHERWOOD AR SAMUEL B. HESTER, PH.D., P.A. JONESBORO AR CHARLES E. REEVES, M.D. HOT SPRINGS AR DENNIS R. VOWELL, JR., PSY.D. PARAGOULD AR MATTIE L. IVY, CCC-SLP FORREST CITY AR MARIA H. BARANDIARAN NASHVILLE AR SOUTHERN MEDICAL GROUP MONTICELLO AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR SOUTHERN MEDICAL GROUP MONTICELLO AR SOUTHERN MEDICAL GROUP WAKE VILLAGE TX RICHARD L. SYLVESTER, PH.D. EL DORADO AR DAI-YUAN WANG, M.D. RUSSELLVILLE AR SAMUEL B. HESTER, PH.D., P.A. HEBER SPRINGS AR SAMUEL B. HESTER, PH.D., P.A. WHITE HALL AR SAMUEL B. HESTER, PH.D., P.A. BLYTHEVILLE AR SAMUEL B. HESTER, PH.D., P.A. MOUNTAIN HOME AR SAMUEL B. HESTER, PH.D., P.A. MARION AR SAMUEL B. HESTER, PH.D, P.A. TEXARKANA AR SAMUEL B. HESTER, PH.D, P.A. DE QUEEN AR JOHN M. FAUCETT, PH.D. CONWAY AR DIANA DRURY CLARK, CCC-SLP CONWAY AR GARRY STEWART, M.D. CONWAY AR JULIE LOWE LITTLE ROCK AR CARA HARTFIELD, PH.D. FAYETTEVILLE AR JEAN ANNE STONE, O.D. GREERS FERRY AR AHMAD AL-KHATIB, M.D. BENTONVILLE AR FORT SMITH HMA LLC FORT SMITH AR FORT SMITH HMA PBC MGMT, LLC FORT SMITH AR CHILDREN'S THERAPY TEAM BENTONVILLE AR KATHRYN L. WEBB, CCC-SLP JONESBORO AR SOUTHERN MEDICAL GROUP BATESVILLE AR SOUTHERN MEDICAL GROUP HOT SPRINGS AR SOUTHERN MEDICAL GROUP BATESVILLE AR GINNY (VIRGINIA) LYNN YOUNG, CCC-SLP SHERWOOD AR SUZANNE MCKENNA, PH.D. ROGERS AR JAVIER SIMANCAS-CHAVEZ LITTLE ROCK AR JESSICA LEE CONN, CCC-SLP MARION AR CRYSTAL D. SAVAGE, CCC-SLP TEXARKANA TX JESSICA WRIGHT, CCC-SLP TEXARKANA TX CAROL W. PEARCY, CCC-SLP TEXARKANA TX FELICIA L. JOHNSON, M.D. (b) (6) SPRINGDALE AR LANCE A. MANNING, M.D. SPRINGDALE AR KEVIN W. LOLLAR, M.D. SPRINGDALE AR JARED R. SPENCER, M.D. SPRINGDALE AR KATHRYN L. SLAY, CCC-SLP LITTLE ROCK AR BILL F. MEARS, M.D. HARRISON AR MEGAN HORNE CAWLFIELD, CCC-SLP FAYETTEVILLE AR ANANDARAJ SUBRAMANIUM M.D. MOUNTAIN VIEW AR SUSAN SKINNER HOLT, PH.D. LITTLE ROCK AR CATHERINE HUBBARD ADAMS, PH.D. JONESBORO AR CLIFFORD LAMAR EVANS, M.D. MORRILTON AR ANITA GAIL WELLS, PH.D. PARAGOULD AR MICHAEL WAYNE PARKER, PH.D. AMITY AR MICHAEL WAYNE PARKER, PH.D. LITTLE ROCK AR MICHAEL WAYNE PARKER, PH.D. HAMPTON AR LEAPS AND BOUNDS THERAPY SERVICES, PLLC CHARLESTON AR SHANNON DOUGLAS PARSONS, PSY.D. BENTON AR ARKANSAS FAMILIES FIRST NORTH LITTLE ROCK AR ARKANSAS FAMILIES FIRST NORTH LITTLE ROCK AR CYNTHIA W. DUPUIS, PH.D.,PA LITTLE ROCK AR CYNTHIA W. DUPUIS, PH.D., PA WHITE HALL AR CYNTHIA W. DUPUIS, PH.D., PA PINE BLUFF AR KENNAN A. DOAN, O.D. LITTLE ROCK AR SANFORD P. HOOPER, O.D. LITTLE ROCK AR STEPHANIE A. WILLETT, O.D. LITTLE ROCK AR MARK E. LAREY, D.O. HOT SPRINGS AR JAMES LEE HOOVER, ED.D. TEXARKANA TX MICHA MORGAN LAMBERSON, CCC-SLP JONESBORO AR KARAS HEALTH CARE FAYETTEVILLE AR KARAS HEALTH CARE FAYETTEVILLE AR BETH LEAH MEYER-BULLEY, PSY.D. MARION AR MARY JANE SONNTAG, PSY.D., PA BENTONVILLE AR KARAS HEALTH CARE LOWELL AR SANDRA J. WILSON, LPE ASHDOWN AR TRANSITIONS PSYCHOLOGICAL SERVICES, PLLC. DE QUEEN AR DON BALL, M.D. PORTLAND AR DAVID BARNETT, M.D. LITTLE ROCK AR KRISTI KETZ, PH.D. BATESVILLE AR CATHERINE COON, PSY.D. HOT SPRINGS AR MARTHA GORE, O.D. FORREST CITY AR ARKANSAS OCCUPATIONAL HEALTH CLINIC VAN BUREN AR ARKANSAS OCCUPATIONAL HEALTH CLINIC SPRINGDALE AR ARKANSAS OCCUPATIONAL HEALTH CLINIC (b) (6) RUSSELLVILLE AR DAWN PARSONS, PSY.D. MALVERN AR SHANNON DOUGLAS PARSONS, PSY.D. MALVERN AR KRISTEN MADDOX, MS, CCC-SLP SHERWOOD AR MELISA LAELAN SPRINGDALE AR HOPE LANDING, INC. EL DORADO AR MEMPHIS MEDICAL ASSOCIATES, INC. MEMPHIS TN DYERSBURG MEDICAL ASSOCIATES, INC. DYERSBURG TN DYERSBURG MEDICAL ASSOCIATES, INC. DYERSBURG TN WEST TENNESSEE PSYCHOLOGICAL SERVICES, INC. MEMPHIS TN ELIZABETH FROMAN, M.D. SPRINGDALE AR RADIOLOGY CONSULTANTS OF LITTLE ROCK LITTLE ROCK AR SAMUEL G. MEREDITH, M.D. PA MARION AR SAMUEL G. MEREDITH, M.D. PA HELENA AR JUAN GALDAMEZ, OD TEXARKANA TX LITTLE ROCK AUDIOLOGY LITTLE ROCK AR VICKIE BREWER CASPALL, PH.D., ABPP-CN WALNUT RIDGE AR LAURA L. WILLIAMS, M.D. LITTLE ROCK AR TRACEE RAINEY, CCC-SLP HOT SPRINGS AR RAVIKUMAR EDALUR, M.D. TEXARKANA TX MARIA C. BANKS FAYETTEVILLE AR JENNIFER BRUMLEY,CCC-SLP OSCEOLA AR KIMBERLY FOX, CCC-SLP PINE BLUFF AR JIVETTE M. DE JESUS BENTONVILLE AR CASEY MOORE, CCC-SLP JACKSONVILLE AR VISION SOURCE OF TEXARKANA TEXARKANA TX CLAUDIA JORDAN, M.D. TEXARKANA TX CAROLINE HOLT, CCC-SLP LITTLE ROCK AR MICHAEL D. GREEN, M.D. SPRINGDALE AR NEXUS DIAGNOSTIC LABORATORIES LITTLE ROCK AR ERNEST CLIFTON, M.D. LITTLE ROCK AR JENNIFER DOYLE, M.D. LITTLE ROCK AR SPEECH PATHOLOGY SERVICES, PLLC TEXARKANA TX JENNIFER E. LOPEZ, M.S., CCC-SLP SPRINGDALE AR KATHY L. MORMAN, MS, CCC-SLP WARREN AR SERENA N. MCKNIGHT, LPE-I SEARCY AR QUANTUM REHABILITATION MAGNOLIA AR KRISTAL M. HILL, MS CCC-SLP FAYETTEVILLE AR BRUCE WENDELL RANDOLPH, M.D. MEMPHIS TN CHRISTINA L. COUCH, PSY.D. RUSSELLVILLE AR JAMES W. CARPENTER, PSY.D. ROGERS AR CHI ST. VINCENT HEART CLINIC ARKANSAS LITTLE ROCK AR KIDABILITIES (b) (6) JONESBORO AR MCFARLAND EYE CENTER HOT SPRINGS AR RODNEY P. GOODWIN, PSY.D. EL DORADO AR THE SPEECH PATH OF NEA, LLC WYNNE AR SAMANTHA S. SHORT, PH.D. CONWAY AR LAURA M. GORDON BELLA VISTA AR FELICIA A. WATKINS-BROWN, M.D. HAMBURG AR RADIOLOGY ASSOCIATES OF THE OZARKS, PLLC RUSSELLVILLE AR CHESTER L. CARLSON, D.O., PLLC FORT SMITH AR CHESTER L. CARLSON, D.O., PLLC FORT SMITH AR BAPTIST HEALTH MEDICAL CENTER - STUTTGART STUTTGART AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR SOUTHERN MEDICAL GROUP BATESVILLE AR SOUTHERN MEDICAL GROUP HOT SPRINGS AR CRYSTAL L. LITTLE, M.D. MONTICELLO AR CONWAY REGIONAL MEDICAL CLINIC - PRINCE ST. CONWAY AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR SOUTHERN MEDICAL GROUP MONTICELLO AR SOUTHERN MEDICAL GROUP BATESVILLE AR BENJAMIN SILBER, PH.D. LITTLE ROCK AR CARSHINA C. VINCENT, CCC-SLP FORREST CITY AR CARSHINA C. VINCENT, CCC-SLP LITTLE ROCK AR CARSHINA C. VINCENT, CCC-SLP PINE BLUFF AR AHMED A. ALI, M.D. CONWAY AR PHILIP M. FURR, M.D. MEMPHIS TN SANDRA THEODORE N. LITTLE ROCK AR ADVANCED FAMILY EYE CARE SPRINGDALE AR SOUTHERN MEDICAL GROUP HOT SPRINGS AR SOUTHERN MEDICAL GROUP BATESVILLE AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR HOLT THERAPY, INC. STUTTGART AR HOLT THERAPY, INC. ENGLAND AR SOUTHERN MEDICAL GROUP BATESVILLE AR SOUTHERN MEDICAL GROUP LITTLE ROCK AR SOUTHERN MEDICAL GROUP MONTICELLO AR KATHLEEN BECKER CABOT AR BYRON J. SIMONEAUX, PH.D. BENTON AR SOUTHERN MEDICAL GROUP HOT SPRINGS AR SOUTHERN MEDICAL GROUP BATESVILLE AR SAMUEL S. BURCHFIELD, M.D. PARAGOULD AR EMILY BENOIT, MS CCC-SLP FORT SMITH AR ELITE EYE CARE & OPTICAL LLC JONESBORO AR RACHEL D. JOHNSON, CCC-SLP (b) (6) JONESBORO AR All Providers Visited in FY 2017 Name Vendor # City State Visit Date VICKIE BREWER CASPALL, PH.D. Walnut Ridge AR 10/12/2016 Keith Norwood, P.E. (b) (6) Jonesboro AR 11/14/2016 ROBERT SPRAY, JR., PH.D. Fort Smith AR 11/14/2016 KEITH NORWOOD P E Fort Smith AR 11/14/2016 PATRICIA WALZ, PH.D. Fort Smith AR 11/15/2016 Patricia Walz, P H .D Fort Smith AR 11/15/2016 PRESCOTT FAMILY CLINIC Prescott AR 11/16/2016 ANTHONY JOHNSON, M.D. Little Rock AR 11/23/2016 NICHOLAUS PAAL, PH.D. Little Rock AR 11/29/2016 CHARLES MALLORY, PH.D. Little Rock AR 11/30/2016 MARTHA GORE, O.D. Forrest City AR 12/2/2016 DAVID LEE WEBBER, D.O. Forrest City AR 12/2/2016 DUPUIS CYNTHIA W Little Rock AR 12/9/2016 Michael Wayne Parker, Ph.D. Little Rock AR 12/9/2016 R. Sam Boyd, PH.D Little Rock AR 12/9/2016 MIRTHA ANARELLA CELLITTI, LPE Little Rock AR 12/9/2016 AHMAD AL-KHATIB, M.D. Bentonville AR 1/11/2017 MICHAEL E. GREEN, M.D. Springdale AR 1/11/2017 ROBERT KARAS, M.D. Fayetteville AR 1/12/2017 TERRY EFIRD, PH.D. Springdale AR 1/12/2017 Richard Back, PH D Fayetteville AR 1/12/2017 J. CHARLES HENRY, M.D. Little Rock AR 1/18/2017 SUDHIR KUMAR, M.D. Forrest City AR 2/2/2017 HOBBY KENNETH PHD Searcy AR 2/2/2017 Kenneth Hobby, Ph.D Searcy AR 2/2/2017 SPELLMANN CHARLES M PH D Monticello AR 2/7/2017 DR TERRY L EFIRD INC Fort Smith AR 2/23/2017 NANCY J. TOOMBS, EDD N. Little Rock AR 2/23/2017 Steve Shry, PH.D Russellville AR 2/23/2017 MICHAEL W PARKER Little Rock AR 2/24/2017 TERRY L. EFIRD, PH.D Fort Smith AR 2/24/2017 Shannon Douglas Parsons, PsyD Benton AR 2/27/2017 James Simpson, M.D. Searcy AR 2/27/2017 JERRY L CUNNINGHAM Blytheville AR 3/2/2017 BRUCE WENDELL RANDOLPH, M.D. Memphis TN 3/2/2016 MEMPHIS NEUROLOGY Memphis TN 3/3/2017 BENNETT L. RUDORFER, M.D. West Memphis AR 3/3/2017 DON BALL, M.D. Dermott AR 3/8/2017 FELICIA A. WATKINS-BROWN, M.D. Hamburg AR 3/8/2017 CRYSTAL L. LITTLE, M.D. Monticello AR 3/8/2017 AR OCCUPATIONAL HEALTH - DR. LOYD Russellville AR 3/13/2017 Ted Honghiran, MD Russellville AR 3/13/2017 SAMUEL B HESTER PHD PA Jonesboro AR 3/17/2017 R SAM BOYD PH D Little Rock AR 3/22/2017 SALMAN HASHMI, M.D. (b) (6) Little Rock AR 3/22/2017 James Moneypenny,PH.D (AR Pysch. Srvcs) Little Rock AR 3/22/2017 BENJAMIN SILBER, PH.D. Little Rock AR 3/22/2017 JONES KENNETH B West Memphis AR 3/28/2017 Dennis Vowell, Jr. Psy D Paragould AR 3/30/2017 JENNIFER DOYLE, M.D. Little Rock AR 3/30/2017 Chester L. Carlson, DO Fort Smith AR 4/18/2017 ANANDARAJ SUBRAMANIUM, M.D. Mtn. View AR 4/19/2017 NANCY A. BUNTING, PH.D. Mtn. Home AR 4/19/2017 Clifford L. Evans, MD Morrilton AR 4/21/2017 KELLY JARRATT, PH.D. - AR FAMILIES FIRST N. Little Rock AR 4/24/2017 GHULAM KHALEEL, M.D. White Hall AR 4/24/2017 KENNETH B. ROBINSON, MS White Hall AR 4/24/2017 MCFARLAND EYE CENTER Hot Springs AR 4/27/2017 LINDA RUNION JOSEF, PH.D. Hot Springs AR 4/27/2017 CASEY A. WELLS, O.D. Paragould AR 5/1/2017 Catherine Adams Ph.D. Jonesboro AR 5/1/2017 AHMED ALI, M.D. Conway AR 6/6/2017 SAMANTHA S. SHORT, PH.D. Conway AR 6/6/2017 DAVID OBERLANDER, M.D. Conway AR 6/6/2017 ROBERT KARAS, M.D. Lowell AR 6/14/2017 AHMAD AL-KHATIB, M.D. Bentonville AR 6/14/2017 STEPHEN NICHOLS, PH.D. Fayetteville AR 6/15/2017 MARY JANE SONNTAG, PSY.D. Bentonville AR 6/15/2017 KEVIN W. LOLLAR, M.D. Springdale AR 6/15/2017 SOUTHWEST PULMONARY ASSOC. Little Rock AR 6/26/2017 DAVID BARNETT, M.D. - ORTHO ARKANSAS Little Rock AR 7/7/2017 INGE CARTER, M.D. Little Rock AR 7/7/2017 JADA HANDWORK, MCD, CCC-SLP Jonesboro AR 7/10/2017 VERYL HODGE, M.D. - CLOPTON CLINIC Jonesboro AR 7/11/2017 BRITTANY BOYETTE, OD - BURKS VISION CLINIC Sherwood AR 7/20/2017 JEAN ANNE STONE, OD Greers Ferry AR 7/20/2017 MELISSA F. JACKSON, PH.D. Pine Bluff AR 7/31/2017 BYRON SIMONEAUX, PH.D. Benton AR 7/31/2017 PAMELA HOLT - HOLT THERAPY England AR 8/8/2017 MARK LAREY, MD - CHI ST VINCENT Hot Springs AR 8/14/2017 CHARLES REEVES, MD - CHI ST VINCENT Hot Springs AR 8/14/2017 B. BATTLE, MD - SOUTHERN MED. GROUP Hot Springs AR 8/14/2017 SOUTHERN MEDICAL GROUP INC Hot Springs AR 8/14/2017 ANN MARIE PRATHER, PH.D. Little Rock AR 8/18/2017 PHILIP M. FURR, MD Memphis TN 8/21/2017 SHANNON BROWNFIELD, MD Harrison AR 8/29/2017 ETHAN WRIGHT, MD Mountain Home AR 8/29/2017 SERENA NICOLE MCKNIGHT, LPE Searcy AR 9/6/2017 Primary Income Providers Visited in FY 2017 Name Vendor # City State Visit Date VICKIE BREWER CASPALL, PH.D. Walnut Ridge AR 10/12/2016 Keith Norwood, P.E. (b) (6) Jonesboro AR 11/14/2016 ROBERT L. SPRAY, JR., PH.D. FORT SMITH AR 11/14/2016 KEITH NORWOOD P E Fort Smith AR 11/14/2016 Patricia Walz, P H .D Fort Smith AR 11/15/2016 Michael Wayne Parker, Ph.D. Little Rock AR 12/9/2016 R. Sam Boyd, PH.D Little Rock AR 12/9/2016 CYNTHIA W. DUPUIS, PH.D., PA LITTLE ROCK AR 12/9/2016 Richard Back, PH D Fayetteville AR 1/12/2017 James Simpson, M.D. Searcy AR 2/2/2017 HOBBY KENNETH PHD Searcy AR 2/2/2017 SPELLMANN CHARLES M PH D Monticello AR 2/7/2017 NANCY J. TOOMBS, EDD N. Little Rock AR 2/23/2017 Kenneth Hobby, Ph.D Searcy AR 2/23/2017 TERRY L. EFIRD, PH.D Fort Smith AR 2/24/2017 Shannon Douglas Parsons, PsyD Benton AR 2/27/2017 CHARLES M. SPELLMANN, PH.D. MONTICELLO AR 2/27/2017 JERRY CUNNINGHAM, PSY.D BLYTHEVILLE AR 3/2/2017 Steve Shry, PH.D Russellville AR 3/13/2017 Samuel B. Hester, PH.D Jonesboro AR 3/17/2017 James Moneypenny,PH.D (AR Pysch. Srvcs) Little Rock AR 3/22/2017 R SAM BOYD PH D Little Rock AR 3/22/2017 SALMAN HASHMI, M.D. Little Rock AR 3/22/2017 KENNETH B. JONES, PH.D. WEST MEMPHIS AR 3/28/2017 JONES KENNETH B West Memphis AR 3/28/2017 Dennis Vowell, Jr. Psy D Paragould AR 3/30/2017 Chester L. Carlson, DO Fort Smith AR 4/18/2017 NANCY A. BUNTING, PH.D MOUNTAIN HOME AR 4/19/2017 Clifford L. Evans, MD Fort Smith AR 4/21/2017 KENNETH B. ROBINSON, MS Forrest City AR 4/24/2017 LINDA RUNION JOSEF, PH.D. HOT SPRINGS AR 4/27/2017 Ted Honghiran, MD Russellville AR 5/1/2017 CATHERINE HUBBARD ADAMS, PH.D. JONESBORO AR 5/1/2017 MARY JANE SONNTAG, PSY.D., PA BENTONVILLE AR 6/15/2017 SOUTHERN MEDICAL GROUP LITTLE ROCK AR 8/14/2017 Joseph Brogdon, M.A. Little Rock AR Deceased $150,000+ Earners Visited in FY 2017 Name City State Amount Visit Date There were no vendors who earned over $150,000 in FY 2016 Top 5 Providers by Dollar Volume Visited in FY 2017 Name City State Amount Visit Date SOUTHERN MEDICAL GROUP INC Little Rock AR 121,988.49 8/14/2017 DR TERRY L EFIRD INC Fort Smith AR 112,915.00 2/23/2017 SAMUEL B HESTER PHD PA Jonesboro AR 108,065.00 3/17/2017 MICHAEL W PARKER Little Rock AR 102,635.00 2/24/2017 DUPUIS CYNTHIA W Little Rock AR 93,840.00 12/9/2016 Vendors Removed for License, Sanction, or Cause in FY 2017

Name Vendor # Date Removed Reason Regional ENT Center 12787 T 2/9/2017 Casey A. Wells 1194326 C 5/10/2017 Nancy Bunting, Ph.D. 38965 D 6/2/2017 (b) (6) CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S05 (Y/N) (Y/N) PROVIDERS COUNT VISITS VISITS S05 $176,348.00 VV (b) (6) PACIFIC HEALTH CLINIC OAKLAND Y Y 1 1 1 1 1 0 S05 $157,239.00 VV PRIORITY ANALYSIS SAN FRANCISCO Y Y 1 1 1 1 1 0 S05 $147,853.00 VV PACIFIC HEALTH CLINIC HAYWARD Y Y 0 1 1 0 1 0 S05 $136,464.00 VV PRIORITY ANALYSIS OAKLAND Y N 0 1 1 0 0 0 S05 $133,237.00 VV BAY VIEW MEDICAL CLINIC SAN FRANCISCO Y Y 0 1 101 0 S05 $132,613.00 VV NORTHSTATE CLINIC SAN FRANCISCO Y N 0 1 1 0 0 0 S05 $125,804.00 VV BAY VIEW MEDICAL CLINIC RICHMOND Y N 0 1 1 0 0 0 S05 $103,924.00 VV BAY VIEW MEDICAL CLINIC SAN LEANDRO Y Y 0 1 1 0 10 S05 $99,553.00 VV PRIORITY ANALYSIS HAYWARD Y Y 0 1 1 0 1 0 S05 $94,372.00 VV HEALTH ANALYSIS/RICHMOND RICHMOND Y N 0 1 1 0 0 0 S05 $89,366.00 VV MDSI PHYSICIAN GROUP OAKLAND Y N 0 1 1 0 0 0 S05 $83,021.00 VV PRIORITY ANALYSIS SANTA CRUZ Y N 0 1 1 0 0 0 S05 $79,191.00 VV AVATAR MEDICAL EXCELLENT NATR NOVATO Y N 0 1 1 0 0 0 S05 $70,989.00 VV NORTHSTATE CLINIC SAN MATEO Y N 0 1 1 0 0 0 S05 $65,264.00 VV BAY VIEW MEDICAL CLINIC FREMONT Y N 0 1 1 0 0 0 S05 $45,215.00 VV MDSI PHYSICIAN GROUP SAN FRANCISCO Y N 0 1 1 0 0 0 S05 $43,264.00 VV PRIORITY ANALYSIS FREMONT Y N 0 1 1 0 0 0 S05 $39,336.00 VV MDSI PHYSICIAN GROUP HAYWARD Y N 0 1 1 0 0 0 S05 $31,438.00 VV BAY VIEW MEDICAL CLINIC OAKLAND Y N 0 1 1 0 0 0 S05 $28,302.00 VV MSLA-MOUNTAIN VIEW MOUNTAIN VIEW Y N 0 1 1 0 0 0 S05 $27,080.00 VV OCEAN DIAGNOSTICS GROUP SAN FRANCISCO Y N 0 1 1 00 0 S05 $14,405.00 VV MSLA-ALAMEDA ALAMEDA Y N 0 1 1 0 0 0 S05 $5,847.00 VV MDSI PHYSICIAN GROUP REDWOOD CITY Y N 0 1 1 0 0 0 S05 $2,298.00 VV PACIFIC HEALTH CLINIC NOVATO Y N 0 1 1 0 0 0 S05 $157,496.00 DL BAY VIEW MEDICAL CLINIC OAKLAND Y Y 11 1 11 0 S05 $51,040.00 DL TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS OAKLAND N N 00 1 00 0 S05 $39,227.00 DL MDSI PHYSICIAN GROUP REDWOOD CITY N N 00 1 00 0 S05 $33,670.00 DL PRIORITY ANALYSIS OAKLAND N N 00 1 00 0 S05 $18,653.00 DL MDSI PHYSICIAN GROUP HAYWARD N N 00 1 00 0 S05 $3,459.00 DL SOKLEY KHOI PHD HAYWARD N N 00 1 00 0 S05 $2,775.00 DL STEVEN MARTINEZ PHD OAKLAND N N 00 1 00 0 S05 $1,638.00 DL MARGARET JONES PHD OAKLAND N N 00 1 00 0 S05 $1,599.00 DL WADE CARTWRIGHT MD OAKLAND N N 00 1 00 0 S05 $1,491.00 DL SOKLEY KHOI PHD EL CERRITO N N 00 1 00 0 S05 $1,348.00 DL MARIA KEROSKY PHD CASTRO VALLEY N N 00 1 00 0 S05 $1,329.00 DL BE WELL PSYCHOLOGICAL SERVICE OAKLAND N N 00 1 00 0 S05 $763.00 DL STEVEN MARTINEZ PHD SAN FRANCISCO N N 00 1 00 0 S05 $756.00 DL L MEBINE OD SAN FRANCISCO N N 00 1 00 0 S05 $726.00 DL PRIORITY ANALYSIS OAKLAND N N 00 1 00 0 S05 $692.00 DL ARNELL ETHERINGTON PHD HALF MOON BAY N N 00 1 00 0 S05 $667.00 DL BRADFORD PIATT MD OAKLAND N N 00 1 00 0 S05 $566.00 DL BE WELL PSYCHOLOGICAL SERVICE OAKLAND N N 00 1 00 0 S05 $546.00 DL ARNELL ETHERINGTON PHD SAN MATEO N N 00 1 00 0 S05 $291.00 DL MARIA KEROSKY PHD CASTRO VALLEY N N 00 1 00 0 S05 $273.00 DL STEVEN MARTINEZ PHD SAN FRANCISCO N N 00 1 00 0 S05 $266.00 DL STEVEN MARTINEZ PHD OAKLAND N N 00 1 00 0 S05 $236.00 DL JIN KIM MD OAKLAND N N 00 1 00 0 S05 2,163.00 DL SOKLEY KHOI PHD HAYWARD NN 00 1 00 0 S05 $133.00 DL LAURENCE LIEF MD SAN FRANCISCO N N 00 1 00 0 S05 $98.00 DL DUDLEY LUKE PHD LOS ALTOS N N 00 1 00 0 S05 $115.00 BP AFFILIATES IN IMAGING OAKLAND N N 00 1 00 0 S05 $130.00 80 UCSF MT ZION MEDICAL CENTER SAN FRANCISCO N N 00 1 00 0 S05 $530.00 79 UCSF MT ZION MEDICAL CENTER SAN FRANCISCO N N 00 1 00 0 S05 $50.00 73 WASHINGTON HOSPITAL/FREMONT FREMONT N N 00 1 00 0 S05 $2,184.00 72 ARNOLD GOLDSCHLAGER MD BURLINGAME N N 00 1 00 0 S05 $848.00 69 GENERAL VASCULAR SURGERY MED SAN LEANDRO N N 00 1 00 0 S05 $67.00 63 WASHINGTON HOSPITAL/FREMONT FREMONT N N 00 1 00 0 S05 $35,326.00 55 CONNIE BROWN AND ASSOCIATES CONNIE BROWN MS CAMPBELL N N 00 1 00 0 S05 $28,511.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS RICHMOND N N 00 1 00 0 S05 $15,336.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER SLP SAN FRANCISCO N N 00 1 00 0 S05 $14,508.00 55 TRANSITIONS SPEECH & LANGUAGEBARBARA VASSER MS OAKLAND N N 00 1 00 0 S05 $428.00 55 BAY AREA SOUND SPEECH & HEARN SAN FRANCISCO N N 00 1 00 0 S05 $428.00 55 GNC THERAPIES SAN RAFAEL N N 00 1 00 0

Page 1 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S05 $153.00 53 MICHAEL CHAN MD SAN FRANCISCO N(Y/N) N(Y/N) PROVIDERS 00COUNT 1 00VISITS VISITS 0 S05 $71.00 51 (b) (6) NORCAL IMAGING SAN LEANDRO N N 00 1 00 0 S05 $26,672.00 47 MARIA KEROSKY PHD OAKLAND N N 00 1 00 0 S05 $24,168.00 47 KIM GOLDMAN PSYD SANTA CRUZ N N 00 1 00 0 S05 $19,873.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD PINOLE N N 00 1 00 0 S05 $16,667.00 47 FAITH TOBIAS PHD HAYWARD N N 00 1 00 0 S05 $16,034.80 47 GARY BALESTIN PHD S SAN FRANCISCO N N 00 1 00 0 S05 $15,810.00 47 FAITH TOBIAS PHD SAN FRANCISCO N N 00 1 00 0 S05 $15,309.00 47 SOKLEY KHOI PHD ALAMEDA N N 00 1 00 0 S05 $14,309.00 47 FAITH TOBIAS PHD SAN LEANDRO N N 00 1 00 0 S05 $10,831.00 47 DEEPA ABRAHAM PHD DUBLIN N N 00 1 00 0 S05 $10,741.00 47 SOKLEY KHOI PHD RICHMOND N N 00 1 00 0 S05 $9,658.00 47 JENNIFER EGGERT PHD SAN FRANCISCO N N 00 1 00 0 S05 $9,468.00 47 HENRY HOEY PHD PLEASANTON N N 00 1 00 0 S05 $9,446.00 47 MARY VIGILANTI EDD BERKELEY N N 00 1 00 0 S05 $8,857.40 47 TELFORD MOORE PHD CORTE MADERA N N 00 1 00 0 S05 $7,101.00 47 LORRAINE SCHNURR PHD BERKELEY N N 00 1 00 0 S05 $6,529.00 47 MARY VIGILANTI EDD HAYWARD N N 00 1 00 0 S05 $3,551.00 47 DAVID PINGITORE PHD OAKLAND N N 00 1 00 0 S05 $2,943.00 47 JENNIFER KIRKLAND PHD ALBANY N N 00 1 00 0 S05 $2,693.00 47 DAVID DAHL PHD CAMPBELL N N 00 1 00 0 S05 $2,273.00 47 NEURO-PSYCH ALLIANCE PLEASANTON N N 00 1 00 0 S05 $1,559.00 47 KIM GOLDMAN PSYD FELTON N N 00 1 00 0 S05 $546.00 47 THOMAS MCCORD PHD LAFAYETTE N N 00 1 00 0 S05 $273.00 47 MARGARET JONES PHD SAN LEANDRO N N 00 1 00 0 S05 $273.00 47 MATTHEW SMITH PSYD FREMONT N N 00 1 00 0 S05 $106.00 47 ASPIRE NEUROPSYCHOLOGICAL SV KEIKO MILLER PSYD WALNUT CREEK N N 00 1 00 0 S05 $667.60 45 LES KALMAN MD SAN FRANCISCO N N 00 1 00 0 S05 $6,827.00 37 CRAGMONT DIAMOND KASSAM MD SAN FRANCISCO N N 00 1 00 0 S05 $11,156.00 36 MARIA KEROSKY PHD OAKLAND N N 00 1 00 0 S05 $5,610.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD PINOLE N N 00 1 00 0 S05 $5,337.00 36 FAITH TOBIAS PHD HAYWARD N N 00 1 00 0 S05 $4,716.00 36 FAITH TOBIAS PHD SAN FRANCISCO N N 00 1 00 0 S05 $3,223.00 36 DAVID PINGITORE PHD OAKLAND N N 00 1 00 0 S05 $3,131.00 36 SOKLEY KHOI PHD ALAMEDA N N 00 1 00 0 S05 $2,598.00 36 GARY BALESTIN PHD S SAN FRANCISCO N N 00 1 00 0 S05 $2,500.00 36 SOKLEY KHOI PHD RICHMOND N N 00 1 00 0 S05 $2,415.00 36 MARY VIGILANTI EDD HAYWARD N N 00 1 00 0 S05 $1,726.00 36 MARY VIGILANTI EDD BERKELEY N N 00 1 00 0 S05 $1,337.00 36 DEEPA ABRAHAM PHD DUBLIN N N 00 1 00 0 S05 $1,176.00 36 JENNIFER EGGERT PHD SAN FRANCISCO N N 00 1 00 0 S05 $1,166.00 36 FAITH TOBIAS PHD SAN LEANDRO N N 00 1 00 0 S05 $1,161.00 36 BARBARA FRANCES PHD SAN FRANCISCO N N 00 1 00 0 S05 $1,086.40 36 TELFORD MOORE PHD CORTE MADERA N N 00 1 00 0 S05 $855.00 36 KIM GOLDMAN PSYD SANTA CRUZ N N 00 1 00 0 S05 $710.00 36 ARNELL ETHERINGTON PHD SAN MATEO N N 00 1 00 0 S05 $670.00 36 DAVID DAHL PHD CAMPBELL N N 00 1 00 0 S05 $302.00 36 KIM GOLDMAN PSYD FELTON N N 00 1 00 0 S05 $22,195.00 35 ADAM MARVIN MD SAN LEANDRO N N 00 1 00 0 S05 $8,115.00 35 KASRA RASTANI MD SAN FRANCISCO N N 00 1 00 0 S05 $781.00 35 IVOR EMANUEL MD SAN FRANCISCO N N 00 1 00 0 S05 $481.00 35 ADAM MARVIN MD OAKLAND N N 00 1 00 0 S05 $10,915.00 33 AUBREY SWARTZ MD OAKLAND N N 00 1 00 0 S05 $3,135.00 31 PACIFIC EYE ASSOCIATES LAURA INGER OD SAN FRANCISCO N N 00 1 00 0 S05 $2,636.00 31 PACIFIC EYE ASSOCIATES MARY KWONG OD SAN FRANCISCO N N 00 1 00 0 S05 $15,149.00 29 BATRA VISION MEDICAL GROUP VINEET BATRA MD SAN LEANDRO N N 00 1 00 0 S05 $13,135.00 29 EYE PHYSICIANS OF THE EAST BAY MICHAEL WANG MD OAKLAND N N 00 1 00 0 S05 $7,786.00 29 EYE PHYSICIANS OF THE EAST BAY JANE LOMAN MD OAKLAND N N 00 1 00 0 S05 $5,338.00 29 EYE PHYSICIANS OF THE EAST BAY STEVEN PASCAL MD OAKLAND N N 00 1 00 0 S05 $4,688.00 29 JOSEPH BARAKEH DO WALNUT CREEK N N 00 1 00 0 S05 $4,416.00 29 MICHAEL GORIN MD ALAMEDA N N 00 1 00 0 S05 $4,349.00 29 BERKELEY OPHTHALMOLOGY MED G BERKELEY N N 00 1 00 0 S05 $3,034.00 29 JAMES COHN MD FREMONT N N 00 1 00 0 S05 $1,878.00 29 MARK DRUCKER MD WALNUT CREEK N N 00 1 00 0

Page 2 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 3 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

S06 $84,634.00 DL MILLENNIUM MULTISPECIALTY MED SANTA ANA N Y removed 00 1 00 1

S06 $84,527.00 DL MILLENNIUM MULTISPECIALTY MED CERRITOS N Y removed 00 1 00 1

S06 $32,055.00 DL MILLENNIUM MULTISPECIALTY MED ALHAMBRA N N removed 00 1 00 0

S06 $15,106.00 DL MILLENNIUM MULTISPECIALTY MED GLENDALE N N removed 00 1 00 0 S06 $9,551.00 DL GNC THERAPIES CERRITOS N N 00 1 00 0 S06 $5,074.00 DL MARTIN GARCIA MD LA PALMA N N 00 1 00 0 S06 $3,912.00 DL METROPOLITAN SPEECH & LANGUAGE CAROL CARLBERG-SNYDER SLP GLENDALE N N 00 1 00 0 S06 $2,311.00 DL ALAN FISHER MD ARCADIA N N 00 1 00 0 S06 $371.00 DL KAYS MEDICAL EVALUATION CENTER WHITTIER N N 00 1 00 0 S06 $286.00 DL SONUS HEARING GLENDALE N N 00 1 00 0 S06 $133.00 DL MARK BERNHARD DO PASADENA N N 00 1 00 0 S06 $103.00 DL SONUS HEARING GLENDALE N N 00 1 00 0 S06 $94.00 DL SOUTHLAND INTERPRETING LILLY ESTRADA DOWNEY N N 00 1 00 0 S06 $43.00 DL ARROWHEAD MEDICAL EVALUATION MONTEREY PARK N N 00 1 00 0 S06 $3,386.00 72 EDWARD ABRAMS MD PARAMOUNT N N 00 1 00 0 S06 $146.00 71 JAMES LIN MD MONTEREY PARK N N 00 1 00 0 S06 $39,670.00 55 TRANSITIONS SPEECH & LANGUAGE LOS ANGELES N N 00 1 00 0 S06 $25,064.00 55 SENSABILITIES SPEECH-LANGUAGE ORANGE N N 00 1 00 0

Page 4 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 5 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S59 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 S59 $726,606.00 VV (b) (6) MEDPRO SERVICES SAN BERNARDINO Y Y 11 1 11 0 S59 $487,240.40 VV S & L MEDICAL GROUP SAN DIEGO Y Y 11 1 22 0 S59 $323,305.00 VV S & L MEDICAL GROUP SAN BERNARDINO Y Y 11 1 11 0 S59 $320,495.00 VV ALTO MEDICAL CLINIC SAN BERNARDINO Y Y 11 1 11 0 S59 $300,581.00 VV QTC MEDICAL GROUP OCEANSIDE Y Y 11 1 11 0 S59 $275,388.00 VV MSLA-SAN DIEGO SAN DIEGO Y Y 11 1 11 0 S59 $253,601.00 VV MEDPRO SERVICES HESPERIA Y Y 11 1 11 0 S59 $128,290.00 VV MSLA-HEMET HEMET Y N 01 1 00 0 S59 $67,171.00 VV CALIFORNIA CARE MEDICAL GROUP APPLE VALLEY YN 01 1 00 0 S59 $58,755.00 VV ALL STATE MEDICAL GROUP BARSTOW Y N 01 1 00 0 S59 $54,427.00 VV MDSI PHYSICIAN GROUP EL CENTRO Y N 01 1 00 0 S59 $50,473.00 VV MSLA-SAN BERNARDINO SAN BERNARDINO Y N 01 1 00 0 S59 $40,568.00 VV ALL STATE MEDICAL GROUP HESPERIA Y N 01 1 00 0 S59 $103,575.80 DL S & L MEDICAL GROUP EL CENTRO N Y 00 1 00 1 S59 $102,823.00 DL S & L MEDICAL GROUP EL CAJON N Y 00 1 00 2 S59 $60,382.26 DL S & L MEDICAL GROUP EL CENTRO N N 00 1 00 0 S59 $43,991.00 DL WILLIAM GORAL MD SAN BERNARDINO N N 00 1 00 0 S59 $18,334.00 DL KENNETH LYNCH PHD CARLSBAD N N 00 1 00 0 (b) (6) S59 $9,747.00 DL MILLENNIUM MULTISPECIALTY MED SAN BERNARDINO N N removed 00 1 00 0 S59 $9,216.00 DL KARA DODDS AND ASSOCIATES KARA DODDS SANTEE N N 00 1 00 0 S59 $4,889.00 DL KENNETH LYNCH PHD CARLSBAD N N 00 1 00 0 S59 $2,987.00 DL MOYAD ORTHOPEDICS THOMAS MOYAD MD LA MESA N N 00 1 00 0 S59 $2,740.00 DL OLUWAFEMI ADEYEMO MD HEMET N N 00 1 00 0 S59 $2,407.00 DL S & L MEDICAL GROUP SAN BERNARDINO N N 00 1 00 0 S59 $1,064.00 DL LINA SCHEIN MD LA MESA N N 00 1 00 0 S59 $583.00 DL CALIFORNIA RETINA ASSOCIATES MAJID MANI MD EL CENTRO N Y 00 1 00 1 S59 $266.00 DL MICHAEL BRAMS MD APPLE VALLEY N N 00 1 00 0 S59 $266.00 DL CHILDRENS PRIMARY CARE MEDICAL DAVID SCHMOTTLACH MD ENCINITAS N N 00 1 00 0 S59 $266.00 DL MOYAD ORTHOPEDICS THOMAS MOYAD MD LA MESA N N 00 1 00 0 S59 $166.00 DL GOLDEN STATE INTERPRETING SRVC SAN DIEGO N N 00 1 00 0 S59 $103.00 DL JOHN BARKER APPLE VALLEY N N 00 1 00 0 S59 $100.00 DL ST BERNARDINE MEDICAL CENTER SAN BERNARDINO N N 00 1 00 0 S59 $72.00 DL ARIAN CEBREROS SAN DIEGO N N 00 1 00 0 S59 $28,882.00 55 LAKIETA EMANUEL SLP HESPERIA N N 00 1 00 0 S59 $12,244.00 55 KARA DODDS AND ASSOCIATES KARA DODDS SANTEE N Y 00 1 00 1 S59 $84,794.00 47 APPLIED PSYCHOLOGY SERVICES DAN WHITEHEAD PHD EL CAJON N N 00 1 00 0 S59 $4,505.00 47 KENNETH LYNCH PHD CARLSBAD N N 00 1 00 0 S59 $3,597.00 47 SHELDON KRAMER PHD ENCINITAS N N 00 1 00 0 S59 $1,426.00 47 WILLIAM SOLTZ PHD SAN BERNARDINO N N 00 1 00 0 S59 $892.00 47 SHELDON KRAMER PHD LA MESA N N 00 1 00 0 S59 $492.00 47 DOUGLAS LARSON PHD COLTON N N 00 1 00 0 S59 $71,355.00 45 JAGANATH GLASSMAN MD LA MESA N N 00 1 00 0 S59 $50,075.00 45 JAGA NATH GLASSMAN MD LA JOLLA N N 00 1 00 0 S59 $41,664.00 45 SAMUEL ETCHIE MD LA MESA N N 00 1 00 0 S59 $6,039.00 45 DIVYAKANT KIKANI MD SAN BERNARDINO N N 00 1 00 0 S59 $13,221.00 37 EFREN VALENZUELA MD SAN BERNARDINO N N 00 1 00 0 S59 $3,687.00 37 THOMAS SCHWELLER MD BRAWLEY N N 00 1 00 0 S59 $1,366.00 36 SHELDON KRAMER PHD LA MESA N N 00 1 00 0 S59 $1,027.00 36 KENNETH LYNCH PHD CARLSBAD N N 00 1 00 0 S59 $228.00 36 DOUGLAS LARSON PHD COLTON N N 00 1 00 0 S59 $176.00 36 SHELDON KRAMER PHD ENCINITAS N N 00 1 00 0 S59 $7,833.00 35 THEODORE MAZER MD SAN DIEGO N N 00 1 00 0 S59 $15,042.00 29 WEST COAST EYE CARE ASSOCIATES GITANE PATEL MD SAN DIEGO N Y 00 1 00 1 S59 $10,666.00 29 EYE PHYSICIANS MEDICAL GROUP CHRISTOPHER HSU MD EL CAJON N N 00 1 00 0 S59 $8,091.00 29 DESERT EYE INSTITUTE NARENDRA PATEL MD EL CENTRO N N 00 1 00 0 S59 $4,321.00 29 WEST COAST EYE CARE ASSOCIATES GITANE PATEL MD EL CAJON N N 00 1 00 0 S59 $3,802.00 29 NORTH COUNTY EYE CENTER ERWIN OMENS MD ESCONDIDO N N 00 1 00 0 S59 $1,046.00 29 EYE PHYSICIANS MEDICAL GROUP RICHARD LEARN MD EL CAJON N N 00 1 00 0 S59 $930.00 29 WEST COAST EYE CARE ASSOCIATES BARRY KATZMAN MD SAN DIEGO N N 00 1 00 0

Page 6 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 7 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S60 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 S60 $371,000.00 VV (b) (6)EWING DIAGNOSTICS & PSYCH SRVS SACRAMENTO YY 11 1 11 0 S60 $280,038.00 VV QTC MEDICAL GROUP SACRAMENTO Y Y 11 1 11 0 S60 $262,813.00 VV MDSI PHYSICIAN GROUP SACRAMENTO Y Y 11 1 11 0 S60 $166,235.00 VV AVATAR MEDICAL EXCELLENT NATRL SANTA ROSA YY 11 1 11 0 S60 $160,968.00 VV BAY VIEW HEALTH NET SACRAMENTO Y Y 11 1 11 0 S60 $105,731.00 VV HEALTH ANALYSIS/SACRAMENTO SACRAMENTO Y N 01 1 00 0 S60 $82,882.00 VV PRIORITY ANALYSIS EUREKA Y N 01 1 00 0 S60 $82,010.00 VV MDSI PHYSICIAN GROUP EUREKA Y N 01 1 00 0 S60 $34,810.00 VV MDSI PHYSICIAN GROUP SANTA ROSA Y N 01 1 00 0 S60 $20,907.00 VV PRIORITY ANALYSIS SACRAMENTO Y Y 01 1 01 0 S60 $18,740.00 VV SHAHID AND RUBY ALI MDs SACRAMENTO Y N 01 1 00 0 S60 $7,864.30 VV MDSI PHYSICIAN GROUP MEDFORD Y N 01 1 00 0 S60 $931.00 VV MSLA-SANTA ROSA SANTA ROSA Y N 01 1 00 0 S60 $133.00 VV MSLA-SACRAMENTO SACRAMENTO Y N 01 1 00 0 S60 $107,400.00 DL PRIORITY ANALYSIS SACRAMENTO N N 00 1 00 0 S60 $48,562.00 DL SHAHID AND RUBY ALI MDs SACRAMENTO N N 00 1 00 0 S60 $11,897.00 DL HILLIS WARREN MD SACRAMENTO N N 00 1 00 0 S60 $8,106.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 00 1 00 0 S60 $6,443.00 DL HERBERT TANENHAUS MD EUREKA N N 00 1 00 0 S60 $6,425.00 DL LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 00 1 00 0 S60 $4,594.00 DL JEANNE BYERS-SPRAETZ SLP SANTA ROSA N N 00 1 00 0 S60 $3,777.00 DL LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 00 1 00 0 S60 $3,160.00 DL HERBERT TANENHAUS MD EUREKA N N 00 1 00 0 S60 $2,795.00 DL JAMES REECE MD SACRAMENTO N N 00 1 00 0 S60 $1,522.00 DL SANFORD BROWN MD FORT BRAGG N N 00 1 00 0 S60 $1,372.00 DL HILLIS WARREN MD SACRAMENTO N N 00 1 00 0 S60 $1,076.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 00 1 00 0 S60 $504.00 DL LANGUAGE WORLD SERVICES SACRAMENTO N N 00 1 00 0 S60 $496.00 DL SARA BOWERMAN PHD CRESCENT CITY N N 00 1 00 0 S60 $333.00 DL AUDIOLOGY ASSOCIATES PETER MARINCOVICH PHD SANTA ROSA N N 00 1 00 0 S60 $323.00 DL KIMEL LIMON PSYD CRESCENT CITY N N 00 1 00 0 S60 $220.00 DL AUDIOLOGY ASSOCIATES SANTA ROSA N N 00 1 00 0 S60 $217.00 DL NORTH COAST AUDIOLOGY EUREKA N N 00 1 00 0 S60 $196.00 DL NORTH COAST OPHTHALMOLOGY ANDREW COCHRANE MD EUREKA N N 00 1 00 0 S60 $171.00 DL JAMES REECE MD SACRAMENTO N N 00 1 00 0 S60 $171.00 DL EYE CARE INSTITUE DAVID LIGHTFOOT MD SANTA ROSA N N 00 1 00 0 S60 $106.00 DL MARCIA HILLARY PHD SACRAMENTO N N 00 1 00 0 S60 $106.00 DL NORTH COAST SURGICAL SPECIALST EUREKA N N 00 1 00 0 S60 $20.00 DL JONATHAN GONICK-HALLOWS PHD SANTA ROSA N N 00 1 00 0 S60 $962.00 BP REDWOOD RADIOLOGY GROUP SANTA ROSA N N 00 1 00 0 S60 $67.00 BP DEL NORTE MEDICAL IMAGING CRESCENT CITY N N 00 1 00 0 S60 $14.00 BP HUMBOLDT RADIOLOGY MEDICAL GRP EUREKA N N 00 1 00 0 S60 $290.00 81 METHODIST HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $75.00 81 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 00 1 00 0 S60 $254.00 80 MERCY GENERAL HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $1,870.00 79 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 00 1 00 0 S60 $1,429.00 79 MERCY GENERAL HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $1,265.00 79 METHODIST HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $450.00 79 ST JOSEPH HOSPITAL EUREKA N N 00 1 00 0 S60 $160.00 79 SUTTER TRACY COMMUNITY HOSP TRACY N N 00 1 00 0 S60 $15,521.80 72 METHODIST HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $160.00 72 SUTTER COAST HOSPITAL CRESCENT CITY N N 00 1 00 0 S60 $312.00 71 METHODIST HOSPITAL SACRAMENTO N N 00 1 00 0 S60 $248.00 69 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 00 1 00 0 S60 $911.78 67 ROBERT THOMAS LCSW SACRAMENTO N N 00 1 00 0 S60 $135.00 63 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N N 00 1 00 0 S60 $12,786.00 55 COOK SPEECH AND LANGUAGE SACRAMENTO N N 00 1 00 0 S60 $9,188.00 55 SANTA ROSA SPEECH & LANGUAGE SANTA ROSA N N 00 1 00 0 S60 $7,824.00 55 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 00 1 00 0 S60 $3,036.00 55 NORTH COAST SPEECH & LANGUAGE EUREKA N N 00 1 00 0 S60 $887.56 55 MORE THAN WORDS SPEECH THERAPY MEDFORD N N 00 1 00 0 S60 $3,106.00 51 DIAGNOSTIC RADIOLOGICAL IMGING SACRAMENTO N N 00 1 00 0 S60 $1,871.00 51 SUTTER IMAGING CAMPUS COMMONS SACRAMENTO N N 00 1 00 0

Page 8 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S60 $543.00 51 SANTA ROSA MEMORIAL HOSPITAL SANTA ROSA N(Y/N) N(Y/N) PROVIDERS 00COUNT 1 00VISITS VISITS 0 S60 $410.00 51 (b) (6)ST JOSEPH HOSPITAL EUREKA N N 00 1 00 0 S60 $138.00 51 SUTTER COAST HOSPITAL CRESCENT CITY N N 00 1 00 0 S60 $39.00 51 SOUTHERN HUMBOLDT COMMUNITY GARBERVILLE N N 00 1 00 0 S60 $43,317.00 47 SILVIA TORREZ PSYD SACRAMENTO N N 00 1 00 0 S60 $41,804.00 47 PHILIP CUSHMAN PHD CLEARLAKE N N 00 1 00 0 S60 $32,983.08 47 SARA BOWERMAN PHD EUREKA N N 00 1 00 0 S60 $29,074.00 47 J NAKAGAWA PHD SACRAMENTO N N 00 1 00 0 S60 $21,878.00 47 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 00 1 00 0 S60 $21,877.00 47 JENNIFER EGGERT PHD SANTA ROSA N N 00 1 00 0 S60 $20,797.96 47 SARA BOWERMAN PHD CRESCENT CITY N N 00 1 00 0 S60 $17,846.00 47 BARRY FINKEL PHD SACRAMENTO N N 00 1 00 0 S60 $13,794.00 47 KIMEL LIMON PSYD CRESCENT CITY N N 00 1 00 0 S60 $9,278.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD SACRAMENTO N N 00 1 00 0 S60 $6,309.00 47 TELFORD MOORE PHD EUREKA N N 00 1 00 0 S60 $3,780.00 47 ALBERT KASTL PHD SANTA ROSA N N 00 1 00 0 S60 $3,106.00 47 LENORE TATE PHD SACRAMENTO N N 00 1 00 0 S60 $2,774.00 47 THINK PAINT FEEL CREATIVE PSY SHYMA ELSAYED PSYD SACRAMENTO N N 00 1 00 0 S60 $1,152.00 47 LISA PERRINE PHD SACRAMENTO N N 00 1 00 0 S60 $819.00 47 SYLVIA HAMILTON PHD SACRAMENTO N N 00 1 00 0 S60 $584.00 47 CHARLES ODIPO PHD SACRAMENTO N N 00 1 00 0 S60 $430.00 47 EDWIN PEARSON PHD MEDFORD N N 00 1 00 0 S60 $3,152.60 45 LES KALMAN MD SANTA ROSA N N 00 1 00 0 S60 $3,050.40 45 LES KALMAN MD EUREKA N N 00 1 00 0 S60 $20.00 45 LES KALMAN MD CLEARLAKE N N 00 1 00 0 S60 $438.00 37 SANFORD CHILDRENS CLINIC KLAMATH FALLS N N 00 1 00 0 S60 $316.00 37 EUREKA PEDIATRICS EUREKA N N 00 1 00 0 S60 $17,940.00 36 SILVIA TORREZ PSYD SACRAMENTO N N 00 1 00 0 S60 $7,629.00 36 SARA BOWERMAN PHD EUREKA N N 00 1 00 0 S60 $7,432.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD SACRAMENTO N N 00 1 00 0 S60 $6,378.00 36 J NAKAGAWA PHD SACRAMENTO N N 00 1 00 0 S60 $4,920.00 36 JENNIFER EGGERT PHD SANTA ROSA N N 00 1 00 0 S60 $4,772.00 36 LUMEN HEALTH & PSYCH SERVICES SACRAMENTO N N 00 1 00 0 S60 $2,649.00 36 BARRY FINKEL PHD SACRAMENTO N N 00 1 00 0 S60 $1,859.00 36 PHILIP CUSHMAN PHD CLEARLAKE N N 00 1 00 0 S60 $1,362.60 36 TELFORD MOORE PHD EUREKA N N 00 1 00 0 S60 $1,147.00 36 THINK PAINT FEEL CREATIVE PSY SHYMA ELSAYED PSYD SACRAMENTO N N 00 1 00 0 S60 $1,013.80 36 SARA BOWERMAN PHD CRESCENT CITY N N 00 1 00 0 S60 $1,003.00 36 CHARLES ODIPO PHD SACRAMENTO N N 00 1 00 0 S60 $900.00 36 EDWIN PEARSON PHD MEDFORD N N 00 1 00 0 S60 $624.00 36 KIMEL LIMON PSYD CRESCENT CITY N N 00 1 00 0 S60 $512.00 36 SYLVIA HAMILTON PHD SACRAMENTO N N 00 1 00 0 S60 $331.00 36 LISA PERRINE PHD SACRAMENTO N N 00 1 00 0 S60 $256.00 36 ALBERT KASTL PHD SANTA ROSA N N 00 1 00 0 S60 $19,516.00 35 SACRAMENTO EAR NOSE AND THROAT SACRAMENTO N N 00 1 00 0 S60 $266.00 33 RICHARD ANDOLSEN MD HEALDSBURG N N 00 1 00 0 S60 $342.00 30 ROYO EYE CENTER SACRAMENTO N N 00 1 00 0 S60 $5,693.00 29 EYE CARE INSTITUE DAN LIGHTFOOT MD SANTA ROSA N N 00 1 00 0 S60 $4,628.00 29 ROYO EYE CENTER SACRAMENTO N N 00 1 00 0 S60 $684.00 29 MARTEL EYE MEDICAL GROUP CHARLES BRADBROOK MD SACRAMENTO N N 00 1 00 0 S60 $392.00 29 NORTH COAST OPHTHALMOLOGY JOHN MASTRONI MD EUREKANN 00 1 00 0 S60 $360.03 29 CATARACT & LASER INSTITUTE OF MEDFORD N N 00 1 00 0 S60 $360.03 29 CATARACT & LASER INSTITUTE OF LOREN BARRUS MD MEDFORD N N 00 1 00 0 S60 $196.00 29 NORTH COAST OPHTHALMOLOGY GREGORY GIBB MD EUREKA NN 00 1 00 0 S60 $13,534.60 23 REBECCA JORDAN MD SACRAMENTO N N 00 1 00 0 S60 $1,596.00 23 RICHARD ANDOLSEN MD HEALDSBURG N N 00 1 00 0 S60 $133.00 22 SHAILESH ASAIKAR MD SACRAMENTO N N 00 1 00 0 S60 $15,230.00 19 JANET OBRIEN MD SACRAMENTO N N 00 1 00 0 S60 $810.00 19 JOHN ALCHEMY MD UKIAH N N 00 1 00 0 S60 $153.00 19 RICHARD ANDOLSEN MD HEALDSBURG N N 00 1 00 0 S60 $12,238.00 03 SACRAMENTO EAR NOSE AND THROAT SACRAMENTO N N 00 1 00 0 S60 $183.00 03 HUMBOLDT AUDIOLOGY EUREKA N N 00 1 00 0 S60 $163.86 03 BASIN AUDIOLOGY LOUIS DUBREY AUD KLAMATHA FALLS N N 00 1 00 0

Page 9 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S61 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 S61 $524,933.00 VV (b) (6)VALLEY HEALTH RESOURCES FRESNO Y Y 11 1 11 0 S61 $506,610.00 VV HEALTH ANALYSIS/MODESTO MODESTO Y Y 11 1 11 0 S61 $409,015.00 VV MDSI PHYSICIAN GROUP FRESNO Y Y 11 1 11 0 S61 $294,327.00 VV HEALTH ANALYSIS/SAN JOSE SAN JOSE Y Y 11 1 11 0 S61 $206,467.00 VV IZZI MEDICAL ASSOCIATES TULARE Y Y 11 1 11 0 S61 $186,651.00 VV MDSI PHYSICIAN GROUP MODESTO Y Y 11 1 11 0 S61 $186,120.00 VV MDSI PHYSICIAN GROUP VISALIA Y Y 11 1 11 0 S61 $178,716.00 VV PRIORITY ANALYSIS SAN JOSE Y Y 11 1 11 0 S61 $104,093.00 VV MSLA-VISALIA VISALIA Y Y 01 1 01 0 S61 $102,908.00 VV BAY VIEW MEDICAL CLINIC SAN JOSE Y Y 01 1 01 0 S61 $72,950.00 VV MDSI PHYSICIAN GROUP SAN JOSE Y Y 01 1 01 0 S61 $72,385.00 VV MSLA-FRESNO FRESNO Y Y 01 1 01 0 S61 $27,755.00 VV MSLA-CLOVIS CLOVIS Y Y 01 1 01 0 S61 $24,825.00 VV EWING DIAGNOSTICS & PSYCH SRVS MODESTO Y Y 01 1 01 0 S61 $31,325.00 DL EWING DIAGNOSTICS & PSYCH SRVS SAN JOSE N N 00 1 00 0 S61 $6,054.00 DL YEN-LINH VU OD GILROY N N 00 1 00 0 S61 $5,790.00 DL ROBERT MORGAN PHD MODESTO N N 00 1 00 0 S61 $4,029.00 DL ROBERT MORGAN PHD MODESTO N N 00 1 00 0 S61 $2,362.00 DL PEGGY JACKSON-SALCEDO PHD FRESNO N N 00 1 00 0 S61 $1,764.00 DL MARY VIGILANTI EDD SAN JOSE N N 00 1 00 0 S61 $1,214.00 DL SUTTER GOULD MEDICAL FNDN MODESTO N N 00 1 00 0 S61 $520.00 DL TERESA FERNANDEZ MODESTO N N 00 1 00 0 S61 $399.00 DL SUTTER GOULD MEDICAL FNDN ANDREA EDGERTON AUD MODESTO N N 00 1 00 0 S61 $291.00 DL MSLA-FRESNO FRESNO N N 00 1 00 0 S61 $212.00 DL EWING DIAGNOSTIC & PSYCH SRVS VISALIA N N 00 1 00 0 S61 $167.00 DL PEGGY JACKSON-SALCEDO PHD FRESNO N N 00 1 00 0 S61 $18.20 BP MINERAL KING RADIOLOGICAL GRP VISALIA N N 00 1 00 0 S61 $847.00 80 KAWEAH DELTA HOSPITAL VISALIA N N 00 1 00 0 S61 $2,250.00 79 KAWEAH DELTA HOSPITAL VISALIA N N 00 1 00 0 S61 $281.00 79 SONORA REGIONAL MEDICAL CENTER SONORA N N 00 1 00 0 S61 $106.00 73 DON GAEDE MD FRESNO N N 00 1 00 0 S61 $1,904.00 72 MOHINDER POONIA MD FRESNO N N 00 1 00 0 S61 $1,242.00 69 DON GAEDE MD FRESNO N N 00 1 00 0 S61 $27.00 63 KAWEAH DELTA HOSPITAL VISALIA N N 00 1 00 0 S61 $48,462.00 55 SPARKMAN SPEECH PATHOLOGISTS MODESTO N N 00 1 00 0 S61 $36,330.00 55 CENTER FOR COMMUNICATION SKILL KATHRYN WAGE MA FRESNO N N 00 1 00 0 S61 $25,746.00 55 CENTER FOR COMMUNICATION SKILL KATHRYN WAGE MA VISALIA N N 00 1 00 0 S61 $5,639.00 51 FRESNO IMAGING CENTER FRESNO N N 00 1 00 0 S61 $4,036.00 51 VALLEY RADIOLOGY MEDICAL ASSOC SAN JOSE N N 00 1 00 0 S61 $369.00 51 WOMENS IMAGING SPECIALISTS IN FRESNO N N 00 1 00 0 S61 $362.00 51 SONORA REGIONAL MEDICAL CENTER SONORA N N 00 1 00 0 S61 $74.00 51 SEQUOIA IMAGING CENTER VISALIA N N 00 1 00 0 S61 $109,371.00 47 STEVEN SWANSON PHD FRESNO N Y 00 1 00 1 S61 $79,907.00 47 JAMES MURPHY PHD FRESNO N N 00 1 00 0 S61 $70,773.00 47 MARY MCDONALD PHD VISALIA N Y 00 1 00 1 S61 $44,614.00 47 PHILIP CUSHMAN PHD MODESTO N N 00 1 00 0 S61 $38,973.20 47 RICHARD ENGELN PHD FRESNO N N 00 1 00 0 S61 $33,522.00 47 ELKE KURPIERS PHD FRESNO N N 00 1 00 0 S61 $16,200.00 47 GREG HIROKAWA PHD VISALIA N N 00 1 00 0 S61 $10,171.00 47 HEALTH & PSYCHOLOGY SOLUTIONS MODESTO N N 00 1 00 0 S61 $8,140.00 47 DAVID PINGITORE PHD MODESTO N N 00 1 00 0 S61 $7,287.00 47 LANCE PORTNOFF PHD VISALIA N N 00 1 00 0 S61 $3,930.00 47 SARA HYATT PSYD SAN JOSE N N 00 1 00 0 S61 $1,676.00 47 LYNNE REINFURT PHD FRESNO N N 00 1 00 0 S61 $745.00 47 MARY VIGILANTI EDD SAN JOSE N N 00 1 00 0 S61 $516.00 47 AIMEE VICKERS-SANCHEZ PHD CLOVIS N N 00 1 00 0 S61 $14,642.00 45 PHILIP CUSHMAN PHD MODESTO N N 00 1 00 0 S61 $78,389.00 36 STEVEN SWANSON PHD FRESNO N N 00 1 00 0 S61 $53,042.00 36 RICHARD ENGELN PHD FRESNO N N 00 1 00 0 S61 $26,896.00 36 MARY MCDONALD PHD VISALIA N N 00 1 00 0 S61 $12,887.00 36 PHILIP CUSHMAN PHD MODESTO N N 00 1 00 0 S61 $11,289.00 36 HEALTH & PSYCHOLOGY SOLUTIONS MODESTO N N 00 1 00 0 S61 $10,674.00 36 SARA HYATT PSYD SAN JOSE N N 00 1 00 0

Page 10 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 11 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S62 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 S62 $228,913.00 VV (b) (6) EWING DIAGNOSTICS & PSYCH SRVS CHICO Y Y 11 1 11 0 S62 $169,417.00 VV EWING DIAGNOSTICS & PSYCH SRVS YUBA CITY Y Y 11 1 11 0 S62 $165,997.00 VV MDSI PHYSICIAN GROUP REDDING Y Y 11 1 11 0 S62 $154,075.00 VV MDSI PHYSICIAN GROUP CHICO Y Y 11 1 11 0 S62 $148,431.00 VV EWING DIAGNOSTICS & PSYCH SRVS ROSEVILLE Y Y 01 1 01 0 S62 $103,295.00 VV MDSI PHYSICIAN GROUP ROSEVILLE Y Y 01 1 01 0 S62 $101,314.00 VV MDSI PHYSICIAN GROUP YUBA CITY Y Y 01 1 01 0 S62 $96,434.00 VV EWING DIAGNOSTICS & PSYCH SRVS EL DORADO HILLS Y Y 01 1 01 0 S62 $91,128.00 VV SHAHID AND RUBY ALI MDS REDDING Y Y 01 1 01 0 S62 $60,793.00 VV MSLA-REDDING REDDING Y Y 01 1 01 0 S62 $41,798.00 VV DIAGNOSTIC EVALUATION SERVICES CHICO Y Y 01 1 01 0 S62 $13,793.00 VV DIAGNOSTIC EVALUATION SERVICES SUSANVILLE Y Y 01 1 01 0 S62 $7,404.00 VV MSLA-CHICO CHICO Y N 01 1 00 0 S62 $6,440.00 VV MSLA-ROSEVILLE ROSEVILLE Y N 01 1 00 0 S62 $3,654.00 VV MSLA-YUBA CITY YUBA CITY Y N 01 1 00 0 S62 $445.00 VV MSLA-LAS VEGAS NV LAS VEGAS Y N 01 1 00 0 S62 $11,317.00 DL ANITA KEMP PHD REDDING N N 00 1 00 0 S62 $10,392.72 DL JANET OBRIEN MD TRUCKEE N N 00 1 00 0 S62 $7,398.00 DL ANITA KEMP PHD MOUNT SHASTA N N 00 1 00 0 S62 $4,922.00 DL MILLER FAMILY MEDICINE WALTER MILLER MD GRASS VALLEY N N 00 1 00 0 S62 $4,203.00 DL RANCHO CORDOVA MEDICAL CLINIC RANCHO CORDOVAN Y 00 1 00 1 S62 $4,122.00 DL MSLA-REDDING REDDING N N 00 1 00 0 S62 $3,678.39 DL SARA BOWERMAN PHD SUSANVILLE N N 00 1 00 0 S62 $2,890.10 DL DEBORAH LACY PSYD S LAKE TAHOE N N 00 1 00 0 S62 $2,002.00 DL SARA BOWERMAN PHD CARMICHAEL N N 00 1 00 0 S62 $1,244.00 DL LANGUAGE WORLD SERVICES ROSEVILLE N N 00 1 00 0 S62 $358.00 DL EWING DIAGNOSTICS & PSYCH SRVS CHICO N N 00 1 00 0 S62 $306.69 DL SARA BOWERMAN PHD SUSANVILLE N N 00 1 00 0 S62 $267.00 DL ENLOE MEDICAL CENTER CHICO N N 00 1 00 0 S62 $248.00 DL SARA BOWERMAN PHD CARMICHAEL N N 00 1 00 0 S62 $216.00 DL CHARLENE CHANG-SMITH MD OROVILLE N N 00 1 00 0 S62 $158.00 DL SURINDER UPPAL MD SUSANVILLE N N 00 1 00 0 S62 $131.00 DL ALEXANDRA CLARFIELD PHD AUBURN N N 00 1 00 0 S62 $120.00 DL FEATHER RIVER HOSPITAL PARADISE N N 00 1 00 0 S62 $107.00 DL NORTH STAR IMAGING MEDICAL GRP SUSANVILLE N N 00 1 00 0 S62 $72.00 DL LANGUAGE WORLD SERVICES EL DORADO HILLS N N 00 1 00 0 S62 $826.67 BP NORTH STATE RADIOLOGY IMAGING CHICO N N 00 1 00 0 S62 $510.00 BP MICHAEL CLEARY MD REDDING N N 00 1 00 0 S62 $103.00 BP PEDIATRIC CARDIOLOGISTS OF NO SACRAMENTO N N 00 1 00 0 S62 $90.00 BP DINESH VERMA MD CHICO N N 00 1 00 0 S62 $72.00 BP MICHAEL MALONEY MD YREKA N N 00 1 00 0 S62 $1,140.00 79 MERCY MEDICAL CENTER REDDING N N 00 1 00 0 S62 $802.00 79 FAIRCHILD MEDICAL CENTER YREKA N N 00 1 00 0 S62 $644.00 79 MERCY SAN JUAN HOSPITAL CARMICHAEL N N 00 1 00 0 S62 $180.00 79 BARTON MEMORIAL HOSPITAL S LAKE TAHOE N N 00 1 00 0 S62 $130.00 79 ENLOE REHABILITATION CENTER CHICO N N 00 1 00 0 S62 $411.00 73 MERCY MEDICAL CENTER REDDING N N 00 1 00 0 S62 $312.00 73 FEATHER RIVER HOSPITAL PARADISE N N 00 1 00 0 S62 $590.20 67 MELINDA ADAMS LCSW REDDING N N 00 1 00 0 S62 $40.00 63 QUEST DIAGNOSTICS UNILAB REDDING N N 00 1 00 0 S62 $33.00 63 ENLOE MEDICAL CENTER CHICO N N 00 1 00 0 S62 $25.00 63 BANNER LASSEN MEDICAL CENTER SUSANVILLE N N 00 1 00 0 S62 $18.00 63 RIDEOUT MEMORIAL HOSPITAL MARYSVILLE N N 00 1 00 0 S62 $5,400.40 55 REDDINGS SPEECH AND LANGUAGE PATRICIA ALBA SLP REDDING N N 00 1 00 0 S62 $4,131.00 55 CHICO SPEECH AND LANGUAGE CHICO N N 00 1 00 0 S62 $514.00 55 THE CONTINUUM RENO N N 00 1 00 0 S62 $428.00 55 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 00 1 00 0 S62 $298.80 55 BARBARA BIONDO TRUCKEE N N 00 1 00 0 S62 $306.00 53 SIERRA RHEUMATOLOGY DOUGLAS HASELWOOD MD ROSEVILLE N N 00 1 00 0 S62 $1,554.00 51 MEDICAL DOCTORS IMAGING REDDING N N 00 1 00 0 S62 $547.00 51 SUTTER BUTTES IMAGING MEDICAL YUBA CITY N N 00 1 00 0 S62 $461.00 51 SUTTER IMAGING FOLSOM I FOLSOM N N 00 1 00 0 S62 $383.00 51 SUTTER IMAGING ROSEVILLE ROSEVILLE N N 00 1 00 0

Page 12 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS S62 $374.33 51 FEATHER RIVER HOSPITAL PARADISE N(Y/N) N(Y/N) PROVIDERS 00COUNT 1 00VISITS VISITS 0 S62 $246.00 51 (b) (6)FAIRCHILD MEDICAL CENTER YREKA N N 00 1 00 0 S62 $181.00 51 SUTTER IMAGING AUBURN AUBURN N N 00 1 00 0 S62 $93.00 51 BANNER LASSEN MEDICAL CENTER SUSANVILLE N N 00 1 00 0 S62 $93.00 51 BARTON MEMORIAL HOSPITAL S LAKE TAHOE N N 00 1 00 0 S62 $65.00 51 SIERRA NEVADA MEMORIAL HOSP GRASS VALLEY N N 00 1 00 0 S62 $129,598.00 47 SID CORMIER PHD REDDING N N 00 1 00 0 S62 $70,049.00 47 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 00 1 00 0 S62 $46,926.00 47 SARA BOWERMAN PHD AUBURN N N 00 1 00 0 S62 $43,232.00 47 JOE AZEVEDO PHD CHICO N N 00 1 00 0 S62 $37,382.97 47 SARA BOWERMAN PHD SUSANVILLE N N 00 1 00 0 S62 $28,030.00 47 LUMEN HEALTH & PSYCH SERVICES YUBA CITY N N 00 1 00 0 S62 $26,559.00 47 VALLEY PSYCHOLOGICAL CENTER ROSEVILLE N N 00 1 00 0 S62 $25,322.00 47 WESTBROOK PSYCHOLOGICAL SVCS CARMICHAEL N N 00 1 00 0 S62 $19,193.00 47 EWING DIAGNOSTICS & PSYCH SRVS PENN VALLEY NN 00 1 00 0 S62 $18,257.00 47 ANITA KEMP PHD MOUNT SHASTA N N 00 1 00 0 S62 $16,074.71 47 SARA BOWERMAN PHD S LAKE TAHOE N N 00 1 00 0 S62 $14,538.40 47 SARA BOWERMAN PHD EL DORADO HILLS N N 00 1 00 0 S62 $14,109.00 47 SARA BOWERMAN PHD CARMICHAEL N N 00 1 00 0 S62 $10,533.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD EL DORADO HILLS N N 00 1 00 0 S62 $10,355.00 47 PSYCHWEST CLINICAL & FORENSIC YUBA CITY N N 00 1 00 0 S62 $10,026.00 47 MAKING A DIFFERENCE COUNSELING GUY WASHINGTON PSYD NORTH HIGHLAND N N 00 1 00 0 S62 $8,177.00 47 MSLA-RENO RENO N N 00 1 00 0 S62 $7,462.00 47 LENORE TATE PHD GOLD RIVER N N 00 1 00 0 S62 $5,879.00 47 KITT MURRISON PHD REDDING N N 00 1 00 0 S62 $4,860.00 47 LEA TATE PSYD REDDING N N 00 1 00 0 S62 $4,224.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD FOLSOM N N 00 1 00 0 S62 $3,976.00 47 DEBORAH LACY PSYD NORTH HIGHLAND N N 00 1 00 0 S62 $3,419.00 47 SUPPORTIVE PSYCHOLOGICAL CARE CYRUS MOAZAM PHD ORANGEVALE N N 00 1 00 0 S62 $2,382.00 47 DEBORAH SCHMIDT PHD AUBURN N N 00 1 00 0 S62 $2,032.00 47 PATRICIA MCVEY PHD FOLSOM N N 00 1 00 0 S62 $1,725.00 47 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD AUBURN N N 00 1 00 0 S62 $727.00 47 ALEXANDRA CLARFIELD PHD AUBURN N N 00 1 00 0 S62 $126.00 47 PSYCHWEST CLINICAL & FORENSIC GRANITE BAY N N 00 1 00 0 S62 $14,130.46 45 LES KALMAN MD YREKA N N 00 1 00 0 S62 $3,604.00 45 KULWANT SINGH MD EL DORADO HILLS N N 00 1 00 0 S62 $1,332.00 45 LENORE TATE PHD GOLD RIVER N N 00 1 00 0 S62 $655.00 45 SANDRA BRANTON EDD S LAKE TAHOE N N 00 1 00 0 S62 $725.00 37 NATIVITY PEDIATRICS EULE BIYO MD FOLSOM N N 00 1 00 0 S62 $11,843.00 36 LUMEN HEALTH & PSYCH SERVICES CITRUS HEIGHTS N N 00 1 00 0 S62 $10,225.00 36 SID CORMIER PHD REDDING N N 00 1 00 0 S62 $4,902.00 36 JOE AZEVEDO PHD CHICO N N 00 1 00 0 S62 $3,738.22 36 SARA BOWERMAN PHD SUSANVILLE N N 00 1 00 0 S62 $3,082.00 36 LEA TATE PSYD REDDING N N 00 1 00 0 S62 $3,038.00 36 WESTBROOK PSYCHOLOGICAL SVCS CARMICHAEL N N 00 1 00 0 S62 $2,653.00 36 SARA BOWERMAN PHD CARMICHAEL N N 00 1 00 0 S62 $1,727.00 36 KITT MURRISON PHD REDDING N N 00 1 00 0 S62 $1,649.00 36 PSYCHWEST CLINICAL & FORENSIC YUBA CITY N N 00 1 00 0 S62 $1,521.00 36 LUMEN HEALTH & PSYCH SERVICES YUBA CITY N N 00 1 00 0 S62 $1,496.00 36 SARA BOWERMAN PHD AUBURN N N 00 1 00 0 S62 $913.00 36 SARA BOWERMAN PHD EL DORADO HILLS N N 00 1 00 0 S62 $853.00 36 VALLEY PSYCHOLOGICAL CENTER ROSEVILLE N N 00 1 00 0 S62 $771.00 36 EWING DIAGNOSTICS & PSYCH SRVS PENN VALLEY N N 00 1 00 0 S62 $603.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD AUBURN N N 00 1 00 0 S62 $336.00 36 DEBORAH SCHMIDT PHD AUBURN N N 00 1 00 0 S62 $331.00 36 PATRICIA MCVEY PHD FOLSOM N N 00 1 00 0 S62 $253.00 36 EL DORADO HILLS PSYCHOLOGICAL MICHAEL MOLYN PSYD EL DORADO HILLS N N 00 1 00 0 S62 $241.10 36 SARA BOWERMAN PHD S LAKE TAHOE N N 00 1 00 0 S62 $216.00 30 ASSOCIATED CHICO EYE SPECIALST ROBERT STONE MD CHICO N N 00 1 00 0 S62 $196.00 30 OROVILLE EYE ASSOCIATES OROVILLE N N 00 1 00 0 S62 $171.00 30 ROYO EYE CENTER GABRIEL JACOB MD ROSEVILLE N N 00 1 00 0 S62 $6,434.00 29 ASSOCIATED CHICO EYE SPECIALST ROBERT STONE MD CHICO N N 00 1 00 0 S62 $5,717.00 29 ROYO EYE CENTER GABRIEL JACOB MD ROSEVILLE N N 00 1 00 0 S62 $3,102.00 29 OROVILLE EYE ASSOCIATES OROVILLE N N 00 1 00 0

Page 13 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 14 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

S90 $39,292.00 DL MILLENNIUM MULTISPECIALTY MED OXNARD N N removed (b) (6) 00 1 00 0

S90 $16,882.00 DL MILLENNIUM MULTISPECIALTY MED VAN NUYS N N removed 00 1 00 0 S90 $5,481.00 DL S & L MEDICAL GROUP ENCINO N N 00 1 00 0 S90 $3,329.00 DL EWING DIAGNOSTICS & PSYCH SRVS TARZANA N N 00 1 00 0 S90 $3,250.00 DL METROPOLITAN SPEECH & LANGUAGE CAROL CARLBERG-SNYDER SLP SHERMAN OAKS N N 00 1 00 0 S90 $3,048.00 DL VERA CECILIO MD TARZANA N N 00 1 00 0 S90 $1,159.00 DL JERROLD SHERMAN MD LOS ANGELES N N 00 1 00 0 S90 $956.00 DL JACOB TSADOK MD LOS ANGELES N N 00 1 00 0 S90 $708.00 DL VERA CECILIO MD TARZANA N N 00 1 00 0 S90 $289.00 DL STEVEN BURRES MD LOS ANGELES N N 00 1 00 0 S90 $282.00 DL PRISM PSYCHOLOGY GROUP KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 00 1 00 0 (b) (6) S90 $173.00 DL MILLENNIUM MULTISPECIALTY MED- VAN NUYS N N removed 00 1 00 0 S90 $171.00 DL WILLIAM FEIN MD BEVERLY HILLS N N 00 1 00 0 S90 $839.00 83 JULES STEIN EYE INSTITUTE STEVEN NUSINOWITZ LOS ANGELES N N 00 1 00 0 S90 $423.00 81 CEDARS-SINAI MEDICAL CENTER ZAB MOHSENIFAR MD LOS ANGELES N N 00 1 00 0 S90 $220.00 79 SANTA BARBARA COTTAGE HOSPITAL SANTA BARBARA N N 00 1 00 0 S90 $130.00 79 CEDARS-SINAI MEDICAL CENTER ZAB MOHSENIFAR MD LOS ANGELES N N 00 1 00 0 S90 $41,705.77 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP OXNARD N N 00 1 00 0 S90 $3,815.00 55 THRIVE & SHINE SPEECH THERAPY NEDA REZAPOOR MS BEVERLY HILLS N N 00 1 00 0 S90 $1,050.00 51 ROLLING OAKS RADIOLOGY VENTURA VENTURA N N 00 1 00 0 S90 $93.00 51 PUEBLO RADIOLOGY MEDICAL GROUP SANTA BARBARA N N 00 1 00 0 S90 $5,430.00 47 STERLING HEALTH CARE SANTA CLARITA N N 00 1 00 0 S90 $4,202.00 47 LANCE PORTNOFF PHD VENTURA N N 00 1 00 0 S90 $3,594.00 47 ISADORE WENDEL PHD CAMARILLO N N 00 1 00 0 S90 $3,095.00 47 DAVID FOX PHD BEVERLY HILLS N N 00 1 00 0 S90 $1,759.00 47 SARA HOUGH PSYD LOS ANGELES N N 00 1 00 0 S90 $1,409.00 47 PSYCH EVAL INC BAHAREH TALEI PHD AGUORA HILLS N N 00 1 00 0 S90 $8,030.00 45 ISADORE WENDEL PHD CAMARILLO N N 00 1 00 0 S90 $969.00 45 MARK SOURIS PSYD WOODLAND HILLS N N 00 1 00 0 S90 $4,443.00 36 LANCE PORTNOFF PHD VENTURA N N 00 1 00 0 S90 $1,370.00 36 SARA HOUGH PSYD LOS ANGELES N N 00 1 00 0 S90 $1,127.00 36 STERLING HEALTH CARE SANTA CLARITA N N 00 1 00 0 S90 $345.00 36 SPECTRUM PSYCHOLOGY NETWORK KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 00 1 00 0 S90 $280.00 36 DAVID FOX PHD BEVERLY HILLS N N 00 1 00 0 S90 $271.00 36 MICHELLE HARRIMAN PSYD SHERMAN OAKS N N 00 1 00 0 S90 $236.00 36 ROGER IZZI PHD SHERMAN OAKS N N 00 1 00 0 S90 $21,424.00 35 KONSTANTIN SALKINDER MD LOS ANGELES N N 00 1 00 0 S90 $16,070.00 35 LAWRENCE STEIN MD WEST HILLS N N 00 1 00 0 S90 $10,301.00 35 CV ENT SURGICAL GROUP VERA CECILIO MD ENCINO N N 00 1 00 0 S90 $1,546.00 33 ARTHUR GARFINKEL MD SANTA CLARITA N N 00 1 00 0 S90 $1,356.00 33 JERROLD SHERMAN MD LOS ANGELES N N 00 1 00 0

Page 15 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 16 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS V04 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 V04 $302,928.00 VV (b) (6)EWING DIAGNOSTICS & PSYCH SRVS STOCKTON Y Y 11 1 11 0 V04 $145,774.10 VV PACIFIC HEALTH CLINIC ANTIOCH Y N 01 1 00 0 V04 $134,636.00 VV AMBERSTONE MEDICAL GROUP STOCKTON Y N 01 1 00 0 V04 $134,132.00 VV MDSI PHYSICIAN GROUP STOCKTON Y N 01 1 00 0 V04 $125,422.00 VV NORTHSTATE CLINIC ANTIOCH Y N 01 1 00 0 V04 $87,993.00 VV HEALTH ANALYSIS/PITTSBURG PITTSBURG Y N 01 1 00 0 V04 $84,048.00 VV BAY VIEW HEALTH NET CONCORD Y N 01 1 00 0 V04 $73,558.00 VV PRIORITY ANALYSIS CONCORD Y N 01 1 00 0 V04 $69,302.00 VV MDSI PHYSICIAN GROUP VALLEJO Y N 01 1 00 0 V04 $63,325.00 VV BAY VIEW HEALTH NET STOCKTON Y N 01 1 00 0 V04 $60,052.00 VV AVATAR MEDICAL EXCELLENT NATRL UKIAH Y N 01 1 00 0 V04 $56,798.00 VV SHAHID AND RUBY ALI MDS STOCKTON Y N 01 1 00 0 V04 $55,596.00 VV EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD Y N 01 1 00 0 V04 $47,092.00 VV BAY VIEW MEDICAL CLINIC VALLEJO Y N 01 1 00 0 V04 $37,743.00 VV MDSI PHYSICIAN GROUP NAPA Y N 01 1 00 0 V04 $37,446.00 VV MDSI PHYSICIAN GROUP CONCORD Y N 01 1 00 0 V04 $36,301.00 VV MDSI PHYSICIAN GROUP VACAVILLE Y N 01 1 00 0 V04 $30,507.00 VV MDSI PHYSICIAN GROUP FAIRFIELD Y N 01 1 00 0 V04 $16,465.00 VV HEALTH ANALYSIS/TRACY TRACY Y N 01 1 00 0 V04 $11,221.00 VV PRIORITY ANALYSIS PETALUMA Y N 01 1 00 0 V04 $4,591.00 VV DIAGNOSTIC EVALUATION SERVICES STOCKTON Y N 01 1 00 0 V04 $3,026.00 VV MSLA-CONCORD CONCORD Y N 01 1 00 0 V04 $89,691.00 DL AVATAR MEDICAL EXCELLENT NATRL LAKEPORT N N 00 1 00 0 V04 $38,068.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 00 1 00 0 V04 $22,636.00 DL PRIORITY ANALYSIS PETALUMA N N 00 1 00 0 V04 $10,887.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 00 1 00 0 V04 $9,986.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 00 1 00 0 V04 $9,041.00 DL CASSANDRA MAJESTIC PSYD DAVIS N N 00 1 00 0 V04 $8,396.00 DL HEALTH ANALYSIS/ANTIOCH ANTIOCH N N 00 1 00 0 V04 $8,044.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 00 1 00 0 V04 $4,894.00 DL SOKLEY KHOI PHD CONCORD N N 00 1 00 0 V04 $4,844.00 DL EDUCATIONAL PSYCHOLOGY AND ROBERT MATTESICH LEP STOCKTON N N 00 1 00 0 V04 $3,616.00 DL MDSI PHYSICIAN GROUP UKIAH N N 00 1 00 0 V04 $3,445.00 DL EWING DIAGNOSTICS & PSYCH SRVS FAIRFIELD N N 00 1 00 0 V04 $2,715.00 DL EDUCATIONAL PSYCHOLOGY AND ROBERT MATTESICH LEP STOCKTON N N 00 1 00 0 V04 $1,621.00 DL PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $1,105.00 DL CASSANDRA MAJESTIC PSYD DAVIS N N 00 1 00 0 V04 $977.00 DL SOKLEY KHOI PHD CONCORD N N 00 1 00 0 V04 $862.00 DL STOCKTON HEARING AND SPEECH STOCKTON N N 00 1 00 0 V04 $576.00 DL LANGUAGE WORLD SERVICES STOCKTON N N 00 1 00 0 V04 $459.00 DL HARINDER AULUCK MD VALLEJO N N 00 1 00 0 V04 $266.00 DL JOHN ALCHEMY MD UKIAH N N 00 1 00 0 V04 $256.00 DL GILLERMO HERRERA PHD STOCKTON N N 00 1 00 0 V04 $216.00 DL LANGUAGE WORLD SERVICES FAIRFIELD N N 00 1 00 0 V04 $196.00 DL JACK MASON MD UKIAH N N 00 1 00 0 V04 $157.00 DL PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $144.00 DL TERESA FERNANDEZ STOCKTON N N 00 1 00 0 V04 $138.00 DL JACK MASON MD UKIAH N N 00 1 00 0 V04 $72.00 DL LANGUAGE WORLD SERVICES DAVIS N N 00 1 00 0 V04 $65.00 DL PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $40.00 DL DANIEL MANDELBAUM MD UKIAH N N 00 1 00 0 V04 $65.00 BP NORTHERN CALIFORNIA IMAGING NAPA N N 00 1 00 0 V04 $24.00 BP DELTA RADIOLOGY MEDICAL GROUP LODI N N 00 1 00 0 V04 $130.00 80 ST JOSEPHS MEDICAL CENTER STOCKTON N N 00 1 00 0 V04 $852.00 79 ST JOSEPHS MEDICAL CENTER STOCKTON N N 00 1 00 0 V04 $90.00 79 QUEEN OF THE VALLEY HOSPITAL NAPA N N 00 1 00 0 V04 $465.00 75 HEART AND HEALTH CENTER DANIEL ANDREWS MD NAPA N N 00 1 00 0 V04 $115.00 73 ST JOSEPHS MEDICAL CENTER STOCKTON N N 00 1 00 0 V04 $2,941.00 72 DANIEL ANDREWS MD NAPA N N 00 1 00 0 V04 $40.00 63 SUTTER SOLANO MEDICAL CENTER VALLEJO N N 00 1 00 0 V04 $35.00 63 PETALUMA VALLEY HOSPITAL PETALUMA N N 00 1 00 0 V04 $28.00 63 SUTTER TRACY COMMUNITY HOSP TRACY N N 00 1 00 0 V04 $23,302.00 55 COMMUNICATION DISORDERS LTD LAWRENCE FRIEDMAN STOCKTON N N 00 1 00 0

Page 17 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS V04 $22,868.00 55 ANBERRY PHYSICAL REHAB CENTER ATWATER N(Y/N) N(Y/N) PROVIDERS 00COUNT 1 00VISITS VISITS 0 V04 $690.00 51 (b) (6)STOCKTON DIAGNOSTIC IMAGING STOCKTON N N 00 1 00 0 V04 $525.00 51 PETALUMA VALLEY HOSPITAL PETALUMA N N 00 1 00 0 V04 $411.00 51 SUTTER LAKESIDE COMMUNITY HOSP LAKEPORT N N 00 1 00 0 V04 $162.00 51 SUTTER TRACY COMMUNITY HOSP TRACY N N 00 1 00 0 V04 $160.00 51 SUTTER SOLANO MEDICAL CENTER VALLEJO N N 00 1 00 0 V04 $43.00 51 UKIAH VALLEY MEDICAL CENTER UKIAH N N 00 1 00 0 V04 $38.00 51 ST JOSEPHS MEDICAL CENTER STOCKTON N N 00 1 00 0 V04 $63,304.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD STOCKTONNN 00 1 00 0 V04 $57,455.00 47 WENDY MCCRAY PHD ELK GROVE N N 00 1 00 0 V04 $42,773.00 47 PHILIP CUSHMAN PHD VALLEJO N N 00 1 00 0 V04 $37,805.00 47 WENDY MCCRAY PHD FAIRFIELD N N 00 1 00 0 V04 $32,658.00 47 GILLERMO HERRERA PHD STOCKTON N N 00 1 00 0 V04 $29,808.00 47 APRIL YOUNG PHD FAIRFIELD N N 00 1 00 0 V04 $27,937.00 47 EWING DIAGNOSTICS & PSYCH SRVS WOODLAND N N 00 1 00 0 V04 $24,096.00 47 APRIL YOUNG PHD PITTSBURG N N 00 1 00 0 V04 $22,152.00 47 PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $17,578.00 47 EDUCATIONAL PSYCHOLOGY COUNSLG JAMES WAKEFIELD PHD STOCKTON N N 00 1 00 0 V04 $14,078.00 47 PETER BRADLEE PHD VACAVILLE N N 00 1 00 0 V04 $12,977.00 47 ALLIANCE ASSESSMENTS APARNA DIXIT PHD NAPA N N 00 1 00 0 V04 $3,770.00 47 LUMEN HEALTH & PSYCH SERVICES FAIRFIELD N N 00 1 00 0 V04 $3,496.00 47 JANET CAIN PHD NAPA N N 00 1 00 0 V04 $3,195.00 47 EDUCATIONAL PSYCHOLOGY & COUNS NANCY GOAD LEP STOCKTON N N 00 1 00 0 V04 $2,311.00 47 JOHN CHELLSEN PHD STOCKTON N N 00 1 00 0 V04 $82,437.20 45 LES KALMAN MD STOCKTON N N 00 1 00 0 V04 $4,188.00 45 PHILIP CUSHMAN PHD VALLEJO N N 00 1 00 0 V04 $4,056.00 45 TERRALYN RENFRO PSYD VACAVILLE N N 00 1 00 0 V04 $4,017.00 45 PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $1,753.40 45 LES KALMAN MD BENICIA N N 00 1 00 0 V04 $196.20 45 LES KALMAN MD NAPA N N 00 1 00 0 V04 $30,891.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD STOCKTONNN 00 1 00 0 V04 $13,769.00 36 GILLERMO HERRERA PHD STOCKTON N N 00 1 00 0 V04 $11,736.00 36 WENDY MCCRAY PHD ELK GROVE N N 00 1 00 0 V04 $5,338.00 36 EDUCATIONAL PSYCHOLOGY COUNSLG JAMES WAKEFIELD PHD STOCKTON N N 00 1 00 0 V04 $5,290.00 36 EWING DIAGNOSTICS & PSYCH SRVS WOODLAND N N 00 1 00 0 V04 $4,217.00 36 PHILIP CUSHMAN PHD VALLEJO N N 00 1 00 0 V04 $2,873.00 36 WENDY MCCRAY PHD FAIRFIELD N N 00 1 00 0 V04 $2,520.00 36 APRIL YOUNG PHD PITTSBURG N N 00 1 00 0 V04 $2,042.00 36 PETER BRADLEE PHD VACAVILLE N N 00 1 00 0 V04 $1,392.00 36 ALLIANCE ASSESSMENTS APARNA DIXIT PHD NAPA N N 00 1 00 0 V04 $1,249.00 36 APRIL YOUNG PHD FAIRFIELD N N 00 1 00 0 V04 $709.00 36 PHILIP CUSHMAN PHD UKIAH N N 00 1 00 0 V04 $553.00 36 LUMEN HEALTH & PSYCH SERVICES FAIRFIELD N N 00 1 00 0 V04 $547.00 36 EDUCATIONAL PSYCHOLOGY & COUNS NANCY GOAD LEP STOCKTON N N 00 1 00 0 V04 $291.00 36 ANDREW FISHER PHD VALLEJO N N 00 1 00 0 V04 $271.00 36 JANET CAIN PHD NAPA N N 00 1 00 0 V04 $1,481.00 30 CENTER FOR SIGHT MANTECA N N 00 1 00 0 V04 $724.00 30 CENTER FOR SIGHT TRACY N N 00 1 00 0 V04 $533.00 30 CENTER FOR SIGHT STOCKTON N N 00 1 00 0 V04 $342.00 30 HERITAGE EYE ASSOCIATES KENNETH MISELIS MD STOCKTON N N 00 1 00 0 V04 $9,344.00 29 REDWOOD EYE CENTER ROGER CARLSON MD VALLEJO N N 00 1 00 0 V04 $8,215.00 29 CENTER FOR SIGHT STOCKTON N N 00 1 00 0 V04 $7,885.00 29 CENTER FOR SIGHT MANTECA N N 00 1 00 0 V04 $7,849.00 29 HERITAGE EYE ASSOCIATES KENNETH MISELIS MD STOCKTON N N 00 1 00 0 V04 $2,926.00 29 CENTER FOR SIGHT TRACY N N 00 1 00 0 V04 $2,147.00 29 CENTER FOR SIGHT STOCKTON N N 00 1 00 0 V04 $968.00 28 CENTER FOR SIGHT STOCKTON N N 00 1 00 0 V04 $797.00 28 CENTER FOR SIGHT MANTECA N N 00 1 00 0 V04 $3,213.00 19 NORTHLAKE INTERNAL MEDICINE JOHN SCHWEIFLER MD LAKEPORT N N 00 1 00 0 V04 $1,729.00 19 SAM SUNDAR MD CONCORD N N 00 1 00 0 V04 $1,430.00 19 C & A MEDICAL GROUP MEHDI AZADI MD VACAVILLE N N 00 1 00 0 V04 $1,237.00 19 GERIATRIC LONG TERM CARE MED BAO NGUYEN MD STOCKTON N N 00 1 00 0 V04 $3,678.00 05 C & A MEDICAL GROUP MEHDI AZADI MD VACAVILLE N N 00 1 00 0 V04 $3,640.00 05 DANIEL ANDREWS MD NAPA N N 00 1 00 0

Page 18 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

Page 19 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

V06 $160,048.00 DL MILLENNIUM MULTISPECIALTY MED LANCASTER Y N removed 11 1 00 0 V06 $69,453.00 DL MDSI PHYSICIAN GROUP LANCASTER N N 00 1 00 0 (b) (6) V06 $33,788.00 DL MILLENNIUM MULTISPECIALTY MED- CORONA N N removed 00 1 00 0

V06 $28,400.00 DL MILLENNIUM MULTISPECIALTY MED VICTORVILLE N N removed 00 1 00 0 V06 $26,930.00 DL MORTON ISRAEL MD CORONA N N 00 1 00 0 V06 $23,487.88 DL EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP PALMDALE N N 00 1 00 0 V06 $218.00 DL S & L MEDICAL GROUP RCH CUCAMONGA N N 00 1 00 0 V06 $32,044.00 55 TRANSITIONS SPEECH & LANGUAGE LANCASTER N N 00 1 00 0 V06 $23,726.00 55 JANET CAMPBELL MA CLAREMONT N N 00 1 00 0 V06 $3,501.79 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP PALMDALE N N 00 1 00 0 V06 $2,378.00 53 ARTHRITIS MEDICAL CLINIC CORONA N N 00 1 00 0 V06 $60,641.00 47 STERLING HEALTH CARE LANCASTER N N 00 1 00 0 V06 $29,028.00 47 SARA HOUGH PSYD LANCASTER N N 00 1 00 0 V06 $2,605.00 47 ADVANCE COUNSELING CENTER LAWRENCE COATES PHD LANCASTER N N 00 1 00 0 V06 $631.00 47 FAMILY GROWTH CLINIC ISADORE WENDEL PHD LANCASTERNN 00 1 00 0 V06 $78.00 47 STEVEN GARMAN PSYD CLAREMONT N N 00 1 00 0 V06 $17,756.00 45 SARA HOUGH PSYD LANCASTER N N 00 1 00 0 V06 $9,887.00 45 FAMILY GROWTH CLINIC ISADORE WENDEL PHD LANCASTER N N 00 1 00 0 V06 $8,347.00 45 TED GREENZANG MD SANTA ANA N N 00 1 00 0 V06 $2,660.00 45 TANYA SCURRY MD ONTARIO N N 00 1 00 0 V06 $725.00 38 TED GREENZANG MD SANTA ANA N N 00 1 00 0 V06 $273.00 38 SARA HOUGH PSYD LANCASTER N N 00 1 00 0 V06 $16,007.00 37 EFREN VALENZUELA MD VICTORVILLE N N 00 1 00 0 V06 $1,596.00 37 MOHAN KUMARATNE MD HUNTINGTON BCH N N 00 1 00 0 V06 $12,758.00 36 STERLING HEALTH CARE LANCASTER N N 00 1 00 0 V06 $3,024.00 36 SARA HOUGH PSYD LANCASTER N N 00 1 00 0 V06 $14,447.00 29 SHELIA WRIGHT-SCOTT MD PALMDALE N N 00 1 00 0 V06 $3,764.00 19 MICHAEL MUMFORD MD SANTA ANA N N 00 1 00 0 V06 $2,060.00 19 MARWAN EDRIS MD LAGUNA HILLS N N 00 1 00 0 V06 $1,064.00 19 FOUNTAIN VALLEY CARDIOLOGY SHANKARLINGA SAINATH MD FOUNTAIN VALLEY N N 00 1 00 0 V06 $399.00 19 ALLERGY & ASTHMA CENTER HENRY LIN MD CHINO N N 00 1 00 0 V06 $2,434.00 05 MICHAEL MUMFORD MD SANTA ANA N N 00 1 00 0 V06 $316.00 05 FOUNTAIN VALLEY CARDIOLOGY SHANKARLINGA SAINATH MD FOUNTAIN VALLEY N N 00 1 00 0

Page 20 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS V59 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 V59 $608,654.00 VV (b) (6) MEDPRO SERVICES RIVERSIDE Y Y 11 1 11 0 V59 $412,904.00 VV DIAMOND MEDICAL GROUP RIVERSIDE Y Y 11 1 11 0 V59 $351,276.00 VV SEAGATE MEDICAL GROUP SAN DIEGO Y Y 11 1 11 0 V59 $254,976.00 VV QTC MEDICAL GROUP PALM SPRINGS Y Y 11 1 11 0 V59 $214,107.00 VV QTC MEDICAL GROUP CHULA VISTA Y Y 11 1 11 0 V59 $213,239.00 VV MSLA-PALM SPRINGS PALM SPRINGS Y Y 11 1 11 0 V59 $163,743.00 VV QTC MEDICAL GROUP TEMECULA Y Y 11 1 11 0 V59 $120,839.00 VV CALIFORNIA CARE MEDICAL GROUP MURRIETA Y N 01 1 00 0 V59 $75,854.00 VV MSLA-RIVERSIDE RIVERSIDE Y N 01 1 00 0 V59 $45,641.00 VV MDSI PHYSICIAN GROUP PALM SPRINGS Y N 01 1 00 0 V59 $11,218.00 VV AMCE PHSYICIANS GROUP SAN DIEGO Y N 01 1 00 0 V59 $3,184.00 VV CONSULTATIVE EXAMINATION SVCS RIALTO Y N 01 1 00 0 (b) (6) V59 $27,665.00 DL MILLENNIUM MULTISPECIALTY MED RIVERSIDE N N removed 00 1 00 0 V59 $9,837.00 DL H ENGELHORN MD SAN DIEGO N N 00 1 00 0 V59 $2,565.00 DL S & L MEDICAL GROUP CHULA VISTA N N 00 1 00 0 V59 $1,769.00 DL WILLIAM CHAPMAN MD NATIONAL CITY N N 00 1 00 0 V59 $1,449.00 DL MARIA HANSEN DSRT HOT SPGS N N 00 1 00 0 V59 $532.00 DL H ENGELHORN MD SAN DIEGO N N 00 1 00 0 V59 $279.00 DL MSLA-PALM SPRINGS PALM SPRINGS N N 00 1 00 0 V59 $246.00 DL WILLIAM JONES PHD PALM DESERT N N 00 1 00 0 V59 $160.00 DL DOWNTOWN HEARING AID CENTER JANET BROWN RIVERSIDE N N 00 1 00 0 V59 $140.00 DL NETWORK INTERPRETING SERVICE SAN DIEGO N N 00 1 00 0 V59 $20.00 DL BAHAA GIRGIS MD RIVERSIDE N N 00 1 00 0 V59 $69.00 81 PARKVIEW COMMUNITY HOSPITAL RIVERSIDE N N 00 1 00 0 V59 $719.00 79 PARKVIEW COMMUNITY HOSPITAL RIVERSIDE N N 00 1 00 0 V59 $56,048.00 55 KARA DODDS AND ASSOCIATES SAN DIEGO N N 00 1 00 0 V59 $33,102.00 55 KELLY BROWN LLC RIVERSIDE N N 00 1 00 0 V59 $16,235.00 55 ASSOCIATED SPEECH PATHOLOGISTS SAN MARCOS N N 00 1 00 0 V59 $11,522.00 55 SENSABILITIES SPEECH-LANGUAGE RIVERSIDE N N 00 1 00 0 V59 $2,618.80 55 CONSTANCE SIEGEL MURRIETA N N 00 1 00 0 V59 $1,608.00 53 ARTHRITIS MEDICAL CLINIC RIVERSIDE N N 00 1 00 0 V59 $52,740.00 47 APPLIED PSYCHOLOGY SERVICES DAN WHITEHEAD PHD SAN DIEGO N N 00 1 00 0 V59 $16,429.00 47 MARCIE GOLDMAN PHD CHULA VISTA N N 00 1 00 0 V59 $13,567.00 47 KIM GOLDMAN PSYD RIVERSIDE N N 00 1 00 0 V59 $1,355.00 47 THE PSYCHOLOGICAL GROUP CHRISTOPHER COOPER PHD RIVERSIDE N N 00 1 00 0 V59 $9,217.00 37 THOMAS SCHWELLER MD SAN DIEGO N N 00 1 00 0 V59 $3,059.00 37 THOMAS SCHWELLER MD SAN MARCOS N N 00 1 00 0 V59 $1,995.00 37 ADVANCED PEDIATRIC MEDICAL JAY SADRIEH MD SAN DIEGO N N 00 1 00 0 V59 $1,749.00 37 TOURAJ SHAFAI MD RIVERSIDE N N 00 1 00 0 V59 $4,063.00 36 KIM GOLDMAN PSYD RIVERSIDE N N 00 1 00 0 V59 $2,002.00 36 MARCIE GOLDMAN PHD CHULA VISTA N N 00 1 00 0 V59 $582.00 36 THE PSYCHOLOGICAL GROUP CHRISTOPHER COOPER PHD RIVERSIDE N N 00 1 00 0 V59 $20,292.00 35 WILLIAM GORAL MD SAN BERNARDINO N N 00 1 00 0 V59 $18,086.00 35 PIERRE RIVET MD SAN DIEGO N N 00 1 00 0 V59 $7,219.00 35 PAUL GOODMAN MD SAN DIEGO N N 00 1 00 0 V59 $662.00 35 PHILIP AZER MD SAN DIEGO N N 00 1 00 0 V59 $14,082.00 29 WALLACE GOLDBAN MD PALM SPRINGS N N 00 1 00 0 V59 $12,241.00 29 PRECISION EYE CARE GORDON MONTGOMERY MD NATIONAL CITY N N 00 1 00 0 V59 $31,249.00 23 THOMAS SCHWELLER MD SAN DIEGO N N 00 1 00 0 V59 $19,864.00 23 THOMAS SCHWELLER MD SAN MARCOS N N 00 1 00 0 V59 $532.00 22 THOMAS SCHWELLER MD SAN DIEGO N N 00 1 00 0 V59 $399.00 22 THOMAS SCHWELLER MD SAN MARCOS N N 00 1 00 0 V59 $1,656.00 19 SENIOR CLINIC OF RIVERSIDE ROBERT NGUYEN MD RIVERSIDE N N 00 1 00 0 V59 $1,395.00 19 PARS SURGERY HOSSAIN SAHLOLBAI MD BLYTHE N N 00 1 00 0 V59 $399.00 19 INTERNAL MEDICINE ASSOCIATES RICHARD FRIEDMAN MD SAN DIEGO N N 00 1 00 0 V59 $2,117.00 05 INTERNAL MEDICINE ASSOCIATES RICHARD FRIEDMAN MD SAN DIEGO N N 00 1 00 0 V59 $160.00 03 MARJORIE HOUSTON ESCONDIDO N N 00 1 00 0 V59 $20.00 03 JOHN HAUPT CCCA CHULA VISTA NN 00 1 00 0

Page 21 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS V61 (Y/N) (Y/N) PROVIDERS 00COUNT 0VISITS 0VISITS 0 V61 $538,107.00 VV (b) (6)MDSI PHYSICIAN GROUP BAKERSFIELD Y Y 11 1 11 0 V61 $137,364.00 VV MDSI PHYSICIAN GROUP MERCED Y Y 01 1 01 0 V61 $131,639.00 VV MDSI PHYSICIAN GROUP SALINAS Y Y 01 1 01 0 V61 $99,458.00 VV IZZI MEDICAL ASSOCIATES SANTA MARIA Y N 01 1 00 0 V61 $91,933.00 VV MSLA-BAKERSFIELD BAKERSFIELD Y Y 01 1 01 0 V61 $90,336.00 VV BAY VIEW MEDICAL CLINIC SALINAS Y Y 01 1 01 0 V61 $77,902.00 VV MDSI PHYSICIAN GROUP SANTA MARIA Y N 01 1 00 0 V61 $63,569.00 VV MDSI PHYSICIAN GROUP SAN LUIS OBISPO Y N 01 1 00 0 V61 $50,703.00 VV PRIORITY ANALYSIS SAN LUIS OBISPO Y N 01 1 00 0 V61 $30,523.00 VV HEALTH ANALYSIS/MARINA MARINA Y N 01 1 00 0 V61 $24,978.00 VV PRIORITY ANALYSIS PRUNEDALE Y N 01 1 00 0 V61 $14,124.00 VV MSLA-MERCED MERCED Y N 01 1 00 0 V61 $1,809.00 VV MSLA-SANTA MARIA SANTA MARIA Y N 01 1 00 0 V61 $95,796.00 DL MDSI PHYSICIAN GROUP MERCED N N 00 1 00 0 V61 $52,257.67 DL EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP BAKERSFIELD N N 00 1 00 0 (b) (6) V61 $38,238.00 DL MILLENNIUM MULTISPECIALTY MED BAKERSFIELD N N removed 00 1 00 0 V61 $11,325.00 DL GARY BARTELL MD SAN LUIS OBISPO N N 00 1 00 0 V61 $7,321.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 00 1 00 0 V61 $7,266.00 DL CHUCK-KWAN LEE MD BAKERSFIELD N N 00 1 00 0 V61 $6,532.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 00 1 00 0 V61 $6,461.00 DL SOCIETY FOR DISABLED CHILDREN SANDI POOLE SLP BAKERSFIELD N N 00 1 00 0 V61 $4,506.00 DL JOHN ZHANG PSYD BAKERSFIELD N N 00 1 00 0 V61 $3,565.00 DL HAILSTON PSYCHOLOGICAL SERVICE LINDSEY HAILSTON PSYD ATASCADERO N N 00 1 00 0 V61 $2,782.00 DL EASTHILLS SPEECH LANGUAGE SRVC CARYN GOVER SLP BAKERSFIELD N N 00 1 00 0 V61 $2,565.00 DL HAILSTON PSYCHOLOGICAL SERVICE KARESA MEEK PSYD ATASCADERO N N 00 1 00 0 V61 $2,474.00 DL FLORENCIO PANGILINAN MD BAKERSFIELD N N 00 1 00 0 V61 $2,424.00 DL CROSS SPEECH & LANGUAGE CTR LOMPOC N N 00 1 00 0 V61 $2,160.00 DL EASTHILLS SPEECH-LANGUAGE SRVC SANDRA MANZO SLP BAKERSFIELD N N 00 1 00 0 V61 $1,277.00 DL NATIONAL PSYCHOLOGICAL EVAL KARESA MEEK PSYD ATASCADERO N N 00 1 00 0 V61 $1,117.00 DL NATIONAL PSYCHOLOGICAL EVAL LINDSEY HAILSTON PSYD ATASCADERO N N 00 1 00 0 V61 $1,029.00 DL PROFESSIONAL INTERPRETING SRVS LIBRADA VELA SANTA MARIA N N 00 1 00 0 V61 $586.00 DL HAILSTON PSYCHOLOGICAL SERVICE LINDSEY HAILSTON PSYD ATASCADERO N N 00 1 00 0 V61 $538.00 DL NATIONAL PSYCHOLOGICAL EVAL LINDSEY HAILSTON PSYD ATASCADERO N N 00 1 00 0 V61 $360.00 DL MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 00 1 00 0 V61 $271.00 DL HAILSTON PSYCHOLOGICAL SERVICE KARESA MEEK PSYD ATASCADERO N N 00 1 00 0 V61 $188.00 DL NATIONAL PSYCHOLOGICAL EVAL KARESA MEEK PSYD ATASCADERO N N 00 1 00 0 V61 $182.83 DL COMPREHENSIVE PULMONARY AND ALPHA ANDERS MD BAKERSFIELD N N 00 1 00 0 V61 $40.00 81 MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 00 1 00 0 V61 $260.00 80 MERCY THERAPY SERVICES MERCED N N 00 1 00 0 V61 $1,290.00 79 MERCY THERAPY SERVICES MERCED N N 00 1 00 0 V61 $1,232.00 79 NATIVIDAD MEDICAL CENTER SALINAS N N 00 1 00 0 V61 $160.00 79 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 00 1 00 0 V61 $185.00 73 NATIVIDAD MEDICAL CENTER SALINAS N N 00 1 00 0 V61 $160.00 73 ST LOUISE REGIONAL HOSPITAL GILROY N N 00 1 00 0 V61 $2,384.00 72 MERCY MEDICAL PAVILION MERCED N N 00 1 00 0 V61 $800.00 72 NATIVIDAD MEDICAL CENTER SALINAS N N 00 1 00 0 V61 $640.00 72 ADVANCED CARDIOLOGY MEDICAL YADVINDER NARANG MD BAKERSFIELD N N 00 1 00 0 V61 $212.00 69 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 00 1 00 0 V61 $215.60 63 MARIAN REGIONAL MEDICAL CENTER SANTA MARIA N N 00 1 00 0 V61 $38.00 63 MERCY MEDICAL PAVILION MERCED N N 00 1 00 0 V61 $28.00 63 SIERRA VISTA REGIONAL CENTER SAN LUIS OBISPO N N 00 1 00 0 V61 $27,200.00 55 CENTRAL COAST LANGUAGE LEARNG JENNIFER DATTILIO MSCC MONTEREY N N 00 1 00 0 V61 $7,998.00 55 CROSS SPEECH AND LANGUAGE CTR LOMPOC N N 00 1 00 0 V61 $7,995.37 55 TED ISAACSON SLP BAKERSFIELD N N 00 1 00 0 V61 $3,464.00 55 BUELLTON MEDICAL CENTER TED ISAACSON SLP BUELLTON N N 00 1 00 0 V61 $3,424.00 55 EASTHILLS SPEECH-LANGUAGE SRVC MAXINE RODRIGUEZ SLP LAMONT N N 00 1 00 0 V61 $3,036.00 55 SOCIETY FOR DISABLED CHILDREN TRACY BATTISTONI SLP BAKERSFIELD N N 00 1 00 0 V61 $428.00 55 SOCIETY FOR DISABLED CHILDREN ANDREA YAKO SLP BAKERSFIELD N N 00 1 00 0 V61 $214.00 55 EASTHILLS SPEECH-LANGUAGE SRVC CARYN GOVER SLP LAMONT N N 00 1 00 0

Page 22 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

JURIS TOTAL PAID SPEC VENDOR # ORG NAME FIRST NAME LAST NAME SUFF CITY VOLUME AND ONSITE REMOVED/ COMMENTS KEY VOLUME TOTAL CE KEY KEY AND NON- DDS KEY REVIEW SANCTIONE PROVIDER AND KEY PROVIDER PROVIDERS VOLUME KEY/VOLUME BRANCH PROVIDERS COMPLETED D COUNT PROVIDER COUNT VISITS PROVIDERS PROVIDERS V61 $1,550.00 51 TRUXTUN RADIOLOGY MEDICAL GRP BAKERSFIELD N(Y/N) N(Y/N) PROVIDERS 00COUNT 1 00VISITS VISITS 0 V61 $1,474.00 51 (b) (6)TEMPLETON IMAGING MEDICAL TEMPLETON N N 00 1 00 0 V61 $931.00 51 MERCED MRI MEDICAL GROUP MERCED N N 00 1 00 0 V61 $818.00 51 DIGITAL MEDICAL IMAGING SANTA MARIA N N 00 1 00 0 V61 $817.00 51 KERN RADIOLOGY MEDICAL GROUP BAKERSFIELD N N 00 1 00 0 V61 $338.00 51 NATIVIDAD MEDICAL CENTER SALINAS N N 00 1 00 0 V61 $291.00 51 SALINAS VALLEY RADIOLOGISTS SALINAS N N 00 1 00 0 V61 $142.00 51 MERCY MEDICAL PAVILION MERCED N N 00 1 00 0 V61 $65.00 51 HAZEL HAWKINS MEMORIAL HOSP HOLLISTER N N 00 1 00 0 V61 $43.00 51 KERN RADIOLOGY MEDICAL GROUP BAKERSFIELD N N 00 1 00 0 V61 $73,727.00 47 MARILYN MARTINEZ PHD BAKERSFIELD N N 00 1 00 0 V61 $57,078.00 47 STEVEN SWANSON PHD MERCED N N 00 1 00 0 V61 $39,718.60 47 KERN PSYCHOLOGICAL SERVICES MICHAEL MUSACCO PHD BAKERSFIELD N N 00 1 00 0 V61 $20,862.00 47 KIM GOLDMAN PSYD CASTROVILLE N N 00 1 00 0 V61 $10,965.00 47 AKIRA SUZUKI PHD BAKERSFIELD N N 00 1 00 0 V61 $9,638.00 47 SEQUOIA PSYCHOTHERAPY CENTER MARK POPPER PHD FRESNO N N 00 1 00 0 V61 $8,962.00 47 MARY VALENTI PHD BAKERSFIELD N N 00 1 00 0 V61 $8,377.00 47 PEGGY JACKSON-SALCEDO PHD ARROYO GRANDE N N 00 1 00 0 V61 $5,324.00 47 ROBERT OROPEZA PHD BAKERSFIELD N N 00 1 00 0 V61 $5,265.00 47 KIM GOLDMAN PSYD GILROY N N 00 1 00 0 V61 $4,694.00 47 JOHN ZHANG PSYD BAKERSFIELD N N 00 1 00 0 V61 $1,230.00 47 PETER RUSSELL PHD ATASCADERO N N 00 1 00 0 V61 $364.00 47 ANDERSON CLINIC CHARLES BILBREY PHD CASTROVILLE N N 00 1 00 0 V61 $318.00 47 LORIN LINDNER PHD FRAZIER PARK N N 00 1 00 0 V61 $258.00 47 THOMAS WYLIE PHD SANTA MARIA N N 00 1 00 0 V61 $258.00 47 NATIONAL PSYCHOLOGICAL EVAL ATASCADERO N N 00 1 00 0 V61 $3,534.00 45 KIM GOLDMAN PSYD GILROY N N 00 1 00 0 V61 $20.00 38 LES KALMAN MD MERCED N N 00 1 00 0 V61 $4,130.00 37 RIVERWALK PEDIATRIC CLINIC HASMUKH AMIN MD BAKERSFIELD N N 00 1 00 0 V61 $61,063.00 36 MARILYN MARTINEZ PHD BAKERSFIELD N N 00 1 00 0 V61 $28,836.00 36 STEVEN SWANSON PHD MERCED N N 00 1 00 0 V61 $17,483.00 36 KERN PSYCHOLOGICAL SERVICES MICHAEL MUSACCO PHD BAKERSFIELD N N 00 1 00 0 V61 $9,739.00 36 MARY VALENTI PHD BAKERSFIELD N N 00 1 00 0 V61 $6,355.00 36 KIM GOLDMAN PSYD CASTROVILLE N N 00 1 00 0 V61 $4,171.00 36 JOHN ZHANG PSYD BAKERSFIELD N N 00 1 00 0 V61 $2,028.00 36 KIM GOLDMAN PSYD GILROY N N 00 1 00 0 V61 $1,771.00 36 PEGGY JACKSON-SALCEDO PHD ARROYO GRANDE N N 00 1 00 0 V61 $355.00 36 LORIN LINDNER PHD FRAZIER PARK N N 00 1 00 0 V61 $291.00 36 NATIONAL PSYCHOLOGICAL EVAL ATASCADERO N N 00 1 00 0 V61 $158.00 36 THOMAS WYLIE PHD SANTA MARIA N N 00 1 00 0 V61 $4,790.00 35 CENTRAL COAST OTOLARYNGOLOGY RICHARD WIKHOLM MD SANTA MARIA N N 00 1 00 0 V61 $8,400.00 31 STEVE RATTY OD BAKERSFIELD N N 00 1 00 0 V61 $1,219.00 30 GRAHAM EYE CLINIC GARY GRAHAM MD MERCED N N 00 1 00 0 V61 $367.00 30 THOMAS WEED MD MERCED N N 00 1 00 0 V61 $7,449.00 29 GRAHAM EYE CLINIC GARY GRAHAM MD MERCED N N 00 1 00 0 V61 $5,143.00 29 ELITE EYECARE MEDICAL GROUP SANTA MARIA N N 00 1 00 0 V61 $3,210.00 29 JOHN CROWDER MD FREEDOM N N 00 1 00 0 V61 $1,310.00 29 HAROLD SCHICK MD MERCED N N 00 1 00 0 V61 $1,191.00 29 JOHN CROWDER MD HOLLISTER N N 00 1 00 0 V61 $759.00 29 THOMAS WEED MD MERCED N N 00 1 00 0 V61 $756.00 29 NATURAL VISION DAVID KAYE MD MADERA N N 00 1 00 0 V61 $756.00 29 NATURAL VISION LOAN NGUYEN MD MADERA N N 00 1 00 0 V61 $3,099.00 23 MONTEREY SPINE AND JOINT GERALD WAHL MD SALINASNN 00 1 00 0 V61 $7,575.00 19 SHAHRAM EHTESHAMI MD DELANO N N 00 1 00 0 V61 $6,544.00 19 LAWRENCE RIEMER MD LOMPOC N N 00 1 00 0 V61 $4,144.00 19 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 00 1 00 0 V61 $6,004.00 05 ADVANCED CARDIOLOGY MEDICAL YADVINDER NARANG MD BAKERSFIELD N N 00 1 00 0 V61 $266.00 05 ANDERSON CLINIC PAUL ANDERSON MD CASTROVILLE N N 00 1 00 0 V61 $1,940.00 03 ANDERSEN HEARING SERVICES BAKERSFIELD N N 00 1 00 0 V61 $124.00 03 HEARING CONSULTANTS OF CALIF JEFFREY DANHAUER PHD LOMPOC NN 00 1 00 0

Page 23 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

V90 $86,405.00 DL MILLENNIUM MULTISPECIALTY MED INGLEWOOD N Y removed 00 1 00 1

V90 $70,529.00 DL MILLENNIUM MULTISPECIALTY MED LYNWOOD N Y removed 00 1 00 1

V90 $57,673.00 DL MILLENNIUM MULTISPECIALTY MED LONG BEACH N Y removed 00 1 00 1 V90 $47,466.00 DL CARMEL MEDICAL GROUP BURBANK N N 00 1 00 0 V90 $3,017.00 DL EAST-WEST EYE INSTITUTE ALBERT DAVIS MD TORRANCE N N 00 1 00 0 V90 $1,617.00 DL RICHARD GLUCKMAN MD SAN PEDRO N N 00 1 00 0 V90 $271.00 DL PRISM PSYCHOLOGY GROUP KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 00 1 00 0 V90 $511.00 83 CALIFORNIA NEUROMEDICAL SRVCS ROSABEL YOUNG MD INGLEWOOD N N 00 1 00 0 V90 $3,222.00 72 STEWART LONKY MD LOS ANGELES N N 00 1 00 0 V90 $47,024.00 55 TRANSITIONS SPEECH & LANGUAGE INGLEWOOD N N 00 1 00 0 V90 $19,348.00 55 BRIGHT BEGINNINGS SPEECH PATH LOS ANGELES N N 00 1 00 0 V90 $13,268.00 55 CLARION SPEECH AND LANGUAGE LETHE WARD SLP COMPTON N N 00 1 00 0 V90 $5,866.00 55 HILLSTOP SPEECH AND LANGUAGE JANET LYNN MA LONG BEACH N N 00 1 00 0 V90 $18,617.00 47 JOHN STEPHENSON PHD TORRANCE N N 00 1 00 0 V90 $1,377.00 47 SPECTRUM PSYCHOLOGY NETWORK KIMBERLY SPITZ-MARES PHD SAN FERNANDO N N 00 1 00 0 V90 $895.00 47 WALTER BROWN PHD CULVER CITY N N 00 1 00 0 V90 $4,075.00 45 ADVANCE COUNSELING CENTER LAWRENCE COATES PHD RIDGECREST N N 00 1 00 0 V90 $12,010.00 37 EFREN VALENZUELA MD LOS ANGELES N N 00 1 00 0 V90 $6,251.00 37 EFREN VALENZUELA MD HAWTHORNE N N 00 1 00 0 V90 $2,715.00 36 JOHN STEPHENSON PHD TORRANCE N N 00 1 00 0 V90 $236.00 36 WALTER BROWN PHD CULVER CITY N N 00 1 00 0 V90 $35,945.00 35 FLAXIE FLETCHER MD LYNWOOD N N 00 1 00 0 V90 $28,879.00 35 JESUS TAN MD LONG BEACH N N 00 1 00 0

Page 24 of 25 CA DDS LIST OF CE PROVIDERS FFY2017

TOTAL OVERSIGHTS COMPLETED: 116 KEY PROVIDER OVERSIGHTS COMPLETED: 68

Page 25 of 25 Colorado FY 2017

CE GROUP NAME CE PROVIDER KEY/VOLUME SITE VISIT INACTIVE REASON FOR INACTIVATION Allied Assessments Jill Anderson TOP 5 Allied Assessments Meredith Campbell TOP 5 Allied Assessments Donald DeGroot TOP 5 Allied Assessments Alicia Gauthier TOP 5 Allied Assessments April Goggans I Allied Assessments Greta Hunter I Allied Assessments Robert Kirchner TOP 5 Allied Assessments William Lewis TOP 5 Allied Assessments Frederick Malmstrom TOP 5 Allied Assessments Margaret McKinney I Allied Assessments Matthew Meija TOP 5 SV Allied Assessments Laura Moran I Allied Assessments Ryan Parsons TOP 5 Allied Assessments Paula Pook TOP 5 Allied Assessments David Solly TOP 5 SV Columbine Physicians Richard Carson TOP 5 SV Columbine Physicians Stephen Creer TOP 5 SV Columbine Physicians Sam Rubinson TOP 5 SV Columbine Physicians David Wallack TOP 5 SV Consulting Psychology Mary Ellen Fontenot PRIMARY CE WORK SV Consulting Psychology Frederick Leidal PRIMARY CE WORK SV Disability Exam Services Alicia Adams I Disability Exam Services Dustin Anderson TOP 5 SV Disability Exam Services Edwin Baca I Disability Exam Services Lauren Bergstrand I Disability Exam Services Samiran Bhattacharya TOP 5 SV Disability Exam Services Ashley Bloom I Disability Exam Services Charlene Borja TOP 5 SV Disability Exam Services Catherine Cooper TOP 5 SV Disability Exam Services Emily Corcoran TOP 5 SV Disability Exam Services Stephanie Cowherd TOP 5 SV Disability Exam Services Michael Dewey TOP 5 SV Disability Exam Services Alex Diaz TOP 5 SV Disability Exam Services Catherine Dunne TOP 5 SV Disability Exam Services Carolynn Francavilla-Brown I Disability Exam Services Hollie Gaeto I Disability Exam Services Emily Gutgsell I Disability Exam Services Aliea Herbert I Disability Exam Services Ryan Jackman TOP 5 SV Disability Exam Services Ronald Jendry I Disability Exam Services Kerry Kamer TOP 5 SV Disability Exam Services Michael Lersten TOP 5 SV Disability Exam Services DES LH I Disability Exam Services Hayley Marcus I Disability Exam Services Michael Matergia I Disability Exam Services Justin Neisler TOP 5 SV Disability Exam Services Anna Plunkett TOP 5 SV Disability Exam Services William Qutub TOP 5 SV Disability Exam Services Scott Rebich TOP 5 SV Disability Exam Services Thomas E. Reynolds TOP 5 SV Disability Exam Services Sarah Robbins TOP 5 SV Disability Exam Services Surieta Scheef TOP 5 SV Disability Exam Services David Valencia TOP 5 SV Disability Exam Services Winay Virkud TOP 5 SV Disability Exam Services Carmen Wong I Johnsen Health Provider Services Travis Anderson I Johnsen Health Provider Services Alexis Carrington I Johnsen Health Provider Services Andrew Cleveland I Johnsen Health Provider Services Kimberly Johnson I Johnsen Health Provider Services Colleen Little I Johnsen Health Provider Services Christopher Meinzen I Johnsen Health Provider Services Matthew Nelson I Johnsen Health Provider Services Brittney Spivak I Johnsen Health Provider Services John Thomas I (b) (6) Johnsen Health Provider Services Tonya Wren I MDSI Lisa Butler TOP 5 SV MDSI Courtney Crance I MDSI Stanley Ginsburg TOP 5 SV MDSI Richard Harrison-Atlas TOP 5 SV MDSI Margaret MacDonald TOP 5 SV MDSI Michael McGuinn TOP 5 SV MDSI Victor Nwanguma I MDSI Lawrence Scibilia TOP 5 SV MDSI John Thomas TOP 5 SV MDSI Kenneth Washburn I QTC Venugopal Damerla I QTC Steven DeCoud I QTC Rosemary Greenslade TOP 5 SV QTC Gilbert Milburn-Westfall TOP 5 SV QTC Dana Monroe I QTC Sohini Parikh TOP 5 SV QTC Judith Ray TOP 5 SV QTC Joseph Sever TOP 5 SV QTC Jane Wells I Jeanne "Lyn" Allen I Karma Ansbacher Roger Ashmore Laurence Aylesworth Larry Barnett I James Baroffio Neiel Baronberg David Benson PRIMARY CE WORK SV John Bermudez Andras Bodini Helen Bowden Dale Bowen Joyce Boyer Mac Bradley Molly Brady David Brown Monica Buettel Merlyn Caywood Nicholas Chariton Cerola Charles I Ernest Chavez Timothy Clark I Natosha Clatterbaugh Victor Cordero Amy Crockett Scott Czarnecki Linda Daguerre Bryan Davis LeAnna DeAngelo Timothy Doenges Anthony Doing Minette Doss Thomas Downes I David Drucker Lara Dunn James Eickelman Sandra Eisemann Holly Estabrook-Doyle I Vadim Fayngersh I Phaedra Fegley Winifred Flanagan Richard Flanigan Robert Foerster David Fohrman Marlene Frankel Edgar Galloway III Lynne Gillick David Good William Graham C. Patrick Green Mark Griffin Linda Gryski Nolan Hathaway Kristin Helvig Aimee Henley Steven Holley Krista Iannuzzi Romeo Icasiano Roseanne Iversen Edward Johnson Terry Jones Katrina Katen I Gina Kim Heather Kim Barton Knox Majd Kobitary Amy Marie Kunstle Stuart Kutz Denise LaGrand Dennis Larson I Ellen Lewis Stephen Lindendaum I Jonathan Lipson I Gary Luckasen Stephen Mackerrow Richard Madsen PRIMARY CE WORK SV Richard Madsen Shanley Mangeot John Mars Brad Marten Morgan McConnaughhay Mark McDonald Bernadette Mills Michael Millsap Yvonne Morrisey William Morton PRIMARY CE WORK SV Timothy Moser PRIMARY CE WORK SV Angela Muri Mary Nel Victor Neufeld Andrew Norris Barbara Novotny Melinda O'Rourke Robert Pelc Nicolette Picerno Jerry Post Lynne Pred I J. Christopher Pruitt J.W. Ragsdale Michael Ricafort T. Kevin Rice Roberta Richardson J. Lewis Romett Kent Rosengren Randy Rottman Brian Scherzer, PhD Jeffrey Schwartz Rebecca Shtulman I Scott Smetana Rebecca Smith Cory Smith Elizabeth Straka Cheryl Straus-Witty Justin Strote Janet Suarez I Gregory Suchon Kenneth Suslak Randall Swaim Russell Thye Brandon Tibbitts Stephen Treat Michael Trowbridge Sarah VanWinkle Maria Vasisht Marc Voelkel Steven Volman Neil Wainwright I Jill Wayne Peter Weingarten Immaculate Wesley Todd Whitsitt Philip Wiley Stephen Witty Martin Wong Martha Young I Kori Ziegler I CE Provider Name City ABIGAIL K HANNA MD - RedLink West Hartford CT FY 2017 ADEBAMIRO ADEDOTUN MD New Haven ADRIAN KLUFAS MD Bridgeport ADVANCED RADIOLOGY CONSULTANTS Fairfield, Selden, Stamford, Stratford, Trumbull, Orange Color Key: ALOK BHARGAVA MD Waterbury Orange Volume Providers AMANDA HERNANDEZ-RIVERA PSYD Bridgeport, Waterbury Yellow: Key Providers AMANDA M. RAY, SLP Milford, West Hartford Purple: Onsite Visits ANDREW PLESHKEVICH PHD Hartford AMERICAN SCHOOL FOR THE DEAF West Hartford Red: Removed from panel ANGELICA VALENTIN COLON PSYD Wethersfield Blue: New Providers ANNA K KLOSINSKA-SALAZAR SLP West Hartford ANNE MARIA ENGLISH LCSW Wethersfield ANNEMARIE MURPHY PHD Bridgeport ANTHONY F CAMPAGNA PHD Hamden ANTHONY ROSELLI MD West Hartford APRIL MCLEAN PSYD Manchester BALAZS SOMOGYI MD Cheshire, Southington BINA ROGINSKY PSYD Woodbridge BRIDGEPORT HOSPITAL Bridgeport BRETT S RAYFORD PHD BRIDGEPORT BROOKE R CARSON PSYD Wethersfield BRUCE FREEDMAN PHD Bloomfield CHARLES A VASSILOPULOS PHD Rockville CHARLOTTE HUNGERFORD HOSPITAL Torrington CHERYL ELLIS PSYD Waterbury CRISTINA L CIOCCA PSYD Hartford CHRISTINA G FOREMAN PHD CCC SLP Hartford CLAUDIA GUEVARA KRASNICKI PSYD Glastonbury CLINICAL LABORATORY PARTNERS LLC Cheshire, Meriden, North Haven, Wallingford CONNECTICUT VALLEY RADIOLOGY PC Bloomfield, Hartford CRAIG W CZARSTY MD - HEALTH ONE OF CONNECTICUT PC Oakville CYNTHIA L NYE PHD - AMCE Rockyhill DAN A OREN MD - REDLINK New Haven DANA MARTINEZ PSYD Bridgeport, Newtown DANBURY HOSPITAL Danbury DANBURY RADIOLOGICAL ASSOCIATES PC Danbury DANIEL BELIN MD Middletown DANIEL R BROCKETT PHD LLC Southbury DAVID F ZITA PHD Old Lyme DAVID K EMMEL MD Wethersfield DAY KIMBALL HOSPITAL Putnam DEBORA A KUSTRON PSYD - AMCE Rockyhill DENISE K STONE PSYD Glastonbury DEREK T NOEL MD - MED PLUS Mansfield DIANA BADILLO MARTINEZ PHD Waterbury DIANE REESE LCSW Wethersfield DUANE F AUSTIN MD West Hartford ELIANA ECHEVERRY SLP - REDLINK West Hartford, Milford EMILY CASEY PSYD Colchester EMILY B LITTMAN PHD Waterbury ERIC FRAZER PSYD New Haven ERICA PRESTON PSYD Danbury ERIN LASHER JACOBSTEIN PSYD Danbury ESTHER L ALFISI EDD Milford EVANGELOS XISTRIS MD Stamford F SCOTT WINSTANLEY PHD New Haven FELIPE HERNANDEZ LCSW Wethersfield FRANCISCO A LOPEZ PHD New Haven FRANK J MONGILLO MD New Haven GIL FREITAS MD East Lyme, Mansfield, South Windsor, Waterbury (2) HARDIK P AMIN MD Derby East Lyme, Mansfield, South Windsor, Bridgeport, HERBERT REIHER, MD - MED PLUS & IMA Waterbury (2) HOSPITAL OF ST RAPHAEL New Haven HOWARD M KRIEGER PHD Waterbury IVETTE COSME SLP Bridgeport JAIMIE BURNS PSYD West Hartford JAN J AKUS MD Norwich JAY M CUDRIN PHD West Hartford JEAN D IRISH PHD - AMCE Bridgeport Avon, Bloomfield, Enfield, Farmington, Glastonbury, JEFFERSON X RAY GROUP INC Granby, Hartford, West Hartford, Wethersfield, Windsor JEFFREY R SANDLER MD Bridgeport JEFFREY S COHEN PHD Stamford JENNIFER SELDEN PHD Groton JERILYN S ALLEN MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, Willimantic JESUS A LAGO MD Bridgeport, Hamden, Hartford, Rye Brook JIE LIU MD Mansfield, South Windsor, Waterbury (2) JOANNE GAYESKI LCSW Wethersfield JOE LEE MD - REDLINK MILFORD JONATHAN WOODHOUSE PSYD Danbury JOSEPH B GUARNACCIA MD LLC Derby JUDITH M MASCOLO MD West Hartford JUDITH ROSENFIELD MA CCC SLP Avon JULIE A KEEN PSYD Bridgeport, Groton KAITLIN M CASTIGLIONE SLP - REDLINK West Hartford, Milford KAITY R HUTCHINSON PSYD New Haven, Oxford KALMAN LEWIS WATSKY MD New Haven KAREN B GOLDFINGER PHD Essex KATHERINE RODRIGUEZ MD South Windsor, Waterbury KATHLEEN J MURPHY PHD Dayville KENNETH S BLATT MD West Hartford KIMBERLY D HENDERSON-KJELLEN PSYD Wethersfield Kristin A. Dilaj MD - NEW ENGLAND CENTER FOR HEARING REHABILITATION Hampton LALITHA PIERI PSYD Wethersfield LANCE HART PHD Branford LASHANDA B HARVEY PSYD Hartford LAWRENCE AND MEMORIAL HOSPITAL New London LIESE FRANKLIN ZITZKAT PSYD LLC New Haven LISA HOLME PSYD Guilford MABEL L TOLEDO SLP Hartford MALLICK Q ALAM MD New Haven MANCHESTER MEMORIAL HOSPITAL Manchester MARC HILLBRAND PHD Cheshire, Middletown MARGARITA HERNANDEZ PHD Wethersfield MARK E KAPLAN, PHD - AMCE Waterbury, Bridgeport Mark I Weinberger PSYD - IMA Bridgeport MARTIN P HASENFELD MD New Haven MAYSA AKBAR PHD New Haven, Oxford MICHAEL A SHTERNFELD MD - MANCHESTER HEARING CENTER South Windsor MICHAEL F REGAN PHD Waterbury MICHAEL JOHNSON PHD Danbury MICHELE KRYNSKI PHD Bloomfield MIDDLESEX HOSPITAL Essex, Marlborough, Middletown MIGDALIA S RIVERA ARZOLA PHD Wethersfield MOHAMED ZANBRAKJI MD South Windsor NAUGATUCK VALLEY RADIO COMPUTERIZED IMAG Waterbury NELSON RIVERA PHD Wethersfield NORWALK HOSPITAL ASSOCIATION Norwalk OCEAN RADIOLOGY ASSOCIATES LLC New London PATRICIA A GARRETT APRN Derby PATRICK CARROLL MD East Lyme, Mansfield PATRICK F ALBERGO MD West Hartford PATRICK J RUSSOLILLO PHD Middletown PENELOPE G COSENTINO PSYD Norwich PETER DONSHIK MD Bloomfield PHILIP S CARDAMONE PSYD Windsor STEVEN POWELL MD - PULMONARY PHYSICIANS OF NORWICH PC Norwich Bethel, Branford, Bridgeport, Bridgeport, Bristol, Danbury, QUEST DIAGNOSTICS INC East Hartford Enfield Essex Farifield Hartford Hartford RADIOLOGIC ASSOCIATES OF MIDDLETOWN Guilford, Middletown, West Haven RADIOLOGY ASSOCIATES INC Cheshire, Hartford RADIOLOGY ASSOCIATES OF HARTFORD PC Hartford RADIOLOGY ASSOCIATES OF WATERBURY Waterbury RADIOLOGY GROUP PC Branford, Hamden RADIOLOGY LLC Essex RAFAEL MORA DE JESUS PHD Hartford RAHIM SHAMSI MD Southbury REBEKAH A JACKSON PSYD New Haven RICHARD M SLUTSKY MD Stamford RITA M DOHERTY EDD Hamden ROBERT J BUNDY MD LLC Willimantic ROBERT M DODENHOFF MD Hartford ROBERT RUSSO MD Bridgeport, Fairfield ROCIO CHANG ANGULO PSYD Hartford RUTH M GRANT PHD Norwalk SANDOR NAGY MD - HOSPITAL OF CENTRAL CT OCCUPATIONAL HEALTH NETWORK Plainville SARAH MULUKULTA MD Derby SEAN T HART PSYD Southington SEKHAR C CHIRUNOMULA MD Monroe SHELDON B GREENBERG MD Norwalk SIDNEY S HOROWITZ PHD Waterbury ST FRANCIS HOSPITAL Hartford ST MARYS HOSPITAL Waterbury STEPHANIE LYNAM PSYD Danbury STEPHEN ROUSE MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, Willimantic STEVEN E KARASHIK PSYD Ridgefield STEVEN GREEN MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, Willimantic STEVEN KAHN MD Meriden SUJATA KALE MD - REDLINK New Haven THOMAS S KOCIENDA PSYD Newtown TORRINGTON RADIOLOGISTS PC Torrington TURGUT YETIL MD Newington VISUAL PERCEPTIONS Vernon WENDY A UNDERHILL PHD Hartford, Torrington WILLIAM BACKUS HOSPITAL Norwich WILLIAM HIGGINS EDD Bethel WILLIAM T CULVINER MD - EASTERN CONNECTICUT ENT PC Colchester, Norwich, Willimantic WINDHAM COMMUNITY MEMORIAL HOSPITAL Willimantic YACOV KOGAN MD Hartford, Waterbury ZAID FADUL MD Rockyhill, Shelton, Stamford, Stratford, Trumbull Volume Providers None

Key Providers Company: Disability Associates of Connecticut LLC Doctors: YACOV KOGAN, MD

Company: Julie A. Keen LLC Doctors: JULIE A. KEEN, PSYD

Company: Med Plus Disability Evaluations INC Doctors: PATRICK CARROLL MD HERBERT REIHER CT FY 2017 DEREK T NOEL MD GIL FREITAS MD KATHERINE RODRIGUEZ MD JIE LIU MD

Company: Hartford Psychological Services LLC Doctors: RAFAEL MORA DE JESUS, PHD ANDREW PLESHKEVICH, PHD LASHANDA B. HARVEY, PSYD

Company: AMCE Physicians Group Doctors: CHERYL ELLIS, PSYD ZAID FADUL, MD DEBORA A KUSTRON, PDYD MARK E. KAPLAN, PHD AMANDA HERNANDEZ-RIVERA, PSYD JEAN D. IRISH, PHD CYNTHIA L. NYE, PHD

CE Providers Removed From Active List Company: AMCE Physicians Group Doctor: RICHARD I. STERNBERG PHD - AMCE Reason: AMCE Physicians Group REGINA P. WILSON, PHD - AMCE Reason: (b) (6)

Onsite Reviews Company: Rahim Shamsi, MD Doctor: RAHIM SHAMSI, MD

Company: Disability Associates of Connecticu,t LLC Doctor: YAKOV KOGAN, MD

Company: CTAME, LLC Doctor: ROBERT M DODENHOFF MD

Company: HARTFORD PSYCHOLOGICAL SERVICES Doctors: RAFAEL MORA DE JESUS, PHD ANDREW PLESHKEVICH, PHD LASHANDA B HARVEY, PSYD

Company: Jan J. Akus, MD Doctor: JAN AKUS, MD

Company: COMPREHENSIVE PSYCHOLOGICAL Doctors: ANGELICA VALENTIN COLON PSYD & ASSESSMENT LILLIAM MARTINEZ LPC LALITHA PIERI PSYD

Company: Vision Associates of Prospect LAWRENCE KLINE, OD CATHERINE GELINAS, OD

Company: Claudia Guevara Krasnicki, PsyD CLAUDIA GUEVARA KRASNICKI, PSYD

New CE Providers Added Doctor: ADVANCED RADIOLOGY CONSULTANTS - ORANGE, CT AMERICAN SCHOOL FOR THE DEAF - WEST HARTFORD, CT CARLITA ELIAS, PSYD CATHERINE GELINAS, OD CYNTHIA L. NYE, PHD DAN A. OREN, MD ELANOR HIRTREITER, PHD JASON A. GOCKEL, PSYD JEAN D. IRISH, PHD KATHIE H. MOFFITT, PHD LAWRENCE KLINE, OD LESLIE A. BURTON, PHD STEPHANIE LYNAM, PSYD SUJATA KALE, MD ZIARA M. KURYS, PSYD

Color Key: Orange Volume Providers Yellow: Key Providers Purple: Onsite Visits

Red: Removed from panel Blue: New Providers PROVIDERS BY LOCATION AND SPECIALTY

WASHINGTON, D.C. 1145 19th St. NW, Suite 506, Washington, DC 20036

Medical Providers License Number Expiration Date LOCATION Dr. Gomez, Marisela 12/31/2018 IMA Office Dr. Nolte, Elizabeth (b) (6) 12/31/2018 IMA Office Dr. Miknowski, Eugene 12/31/2018 1145 19th St. NW, Suite 504, WDC 20036 Dr. Magurno, Justine 12/31/2018 IMA Office Dr. Miller, Gary 12/31/2018 2440 M St NW #810, Washington, DC 20037 Dr. Pulver, David 12/31/2018 IMA Office Dr. Taubin, Joel 12/31/2018 1145 19th St. NW, Suite 504, WDC 20036

Psych Providers License Number Expiration Date LOCATION Dr. Arnold, James 12/31/2017 IMA Office Dr. Campfield, Tracey (b) (6) 12/31/2017 IMA Office Dr. Chaudhry-Jewani, Rukhsana 12/31/2017 IMA Office Dr. Christman, Jennifer 12/31/2017 IMA Office Dr. Clyburn, Sonya 12/31/2017 IMA Office Dr. Coleman-King, Maia 12/31/2017 IMA Office Dr. Crumpton, Howard 12/31/2017 IMA Office Dr. Dubro, Alan 12/31/2017 IMA Office Dr. Johnson, Stephanie 12/31/2017 IMA Office Dr. Kalhor, Mona 12/31/2017 IMA Office Dr. Maramark -Thomas, Sheilah 12/31/2017 IMA Office Dr. Price, Gregory 12/31/2017 IMA Office Dr. Siddique, Hoorie 12/31/2017 (b) (6) , SILVER SPRING, MD 2091 Dr. Weinberger, Mark 12/31/2017 IMA Office

Audio License Number Expiration Date LOCATION Dr. Randolph, Patricia (b) (6) 12/31/2018 11120 New Hampshire Ave, Ste 504, Silver Spring, MD 20904. (301)593-3200

Updated 8/04/14 DH PROVIDERS BY LOCATION AND SPECIALTY

ENT License Number Expiration Date LOCATION Dr. Myers, Ernest (b) (6) 12/31/2018 11120 New Hampshire Ave, Ste 504, Silver Spring, MD 20904. (301)593-3200

Eye License Number Expiration Date LOCATION Dr. Nasrallah, Fadi (b) (6) 12/31/2018 1145 19th St. NW, Ste 500, WDC 20036. (202)833-1668 Dr. Heffez, Jordan (b) (6) 12/31/2018 1145 19th St. NW, Ste 500, WDC 20036. (202)833-1668

Speech License Number Expiration Date LOCATION Ms. Jacobs, Tiffany 12/31/2018 IMA Office Ms. Luks, Jillian (b) (6) 12/31/2018 IMA Office Ms. Jatene, Gabriela 12/31/2018 IMA Office

Updated 8/04/14 DH Florida FY 2017

DDS Provider List * DDD only vendor * Top Five * Onsite Reviews Inactive CE Vendor Reason Sameh Elamir , MD A PLUS ASSOCIATED THERAPY PRO John Dawson, MD

A SPEECH, HEARING & STRESS CLINIC DFS Walk-In Clinic (b) (6)

A.T. RADIOLOGY P.A. Samuel Rand, MD AARON LIEBMAN AUD Richard Reines, MD

ABBEY EYE CLINIC Jonas Trinidad, PhD

ABBY CIOSICI SLP ABBY CIOSICI, SLP *ABDUL BARI MD ACADEMY EYE CARE **ACCESS BEHAVIORAL CARE ASSOCIATES *ACG THERAPY CENTER INC ADA RAMIREZ PHD ADAM GREENFIELD, DO Addys Prieto,Psy.D. Adele Besner, Psy.D. ADVANCED IMAGING CENTER INC Afzal Khan MD AGGARWAL MEDICAL ASSOC PA AIMEE JENNINGS, M.S. CCC-SLP Alan Kohn MD ALAN LANE MD ALAN MARCUS,D.O. ALEJANDRO J. ARIAS,PSY.D. *ALEXANDER NEIMAN, MD ALISA TALKINGTON, PSYD ALISON GROSSMAN, PH.D. ALL ACCESS THERAPY AND REHAB ALLISON TARBOX, PSYD ALPHA AUDIOLOGY *ALVAN BARBER MD-ORMOND BEACH **ALVAN W BARBER MD ALVAREZ AUDIOLOGY AND HEARING **AMCE: ERE

AMERICAN PSYC. CONSULTANTS AND MULTICULTURAL SERV. ANDREA CHAPMAN SLP ANDRES NAZARIO, JR., PH.D. ANEESA AHMAD MD ANELE DIAZ ANGEL MARTINEZ PHD-ERE ANGELA C. BRINSON, PH.D. *ANGELA HENDERSON, PHD ANILKUMAR PATEL MD ANITA PATEL MD ANN L JACOBS PHD ANOOP K REDDY, MD ANTONIO PRADO, MD, PA ARC GATEWAY INC ARCHBOLD MEMORIAL HOSPITAL ASHOK MITTAL, MD ASMA SYED, MD **ASSESSMENT & TREATMENT CENTERS, INC. ASSOCIATES FOR EVALUATION & THERAPY AUDIOLOGY CONSULTANTS OF PANAMA CITY *AUTUMN MURPHY SLP - TALLAHASSEE AVP ASSESSMENT SERVICES AYMAN ABOULELA MD AZZAM ADHAL MD *Badri N. Mehrotra, M.D. BARBARA M PAULILLO, PSYD PA BAY AREA HEART CENTER BAY MEDICAL CENTER - RESPIRATORY LAB *BAY PC PRIME MEDICAL BAY RADIOLOGY ASSOCIATES PA BAYFRONT HEALTH BROOKSVILLE BAYFRONT HEALTH PORT CHARLOTTE BEATRIZ AMADOR, PSY.D., P.A. BEE RIDGE VISION CENTER BEHAVIORAL HEALTH OF NORTH FLORIDA Belinda Slater SLP BELL PSYCHOLOGICAL SERVICES INC BELTRAN BEHAVIORAL HEALTH LLC BENEFICIAL HEARING AID CENTER BENJAMIN N COHEN PHD **BETH INGRAM & ASSOCIATES *BHUPENDRA GUPTA MD BI-COUNTY SPEECH LANGUAGE PATHOLOGY, INC. BILINGUAL SPEECH LANGUAGE PATHOLOGY CENTER, INC. BILINGUAL THERAPY SERVICES LLC **BILLIE JO HATTON PHD BIRD EYE INSTITUTE BIRDS OF PARADISE PSYCHOLOGICAL SERVICES BRADLEY J BRADFORD MD BREVARD EAR NOSE & THROAT **BRIGHTSIDE HEALTH LLC BROADWATER HEARING CARE BROOKSVILLE EYE CENTER BROWARD THERAPY ASSOCIATES BRUCE R HOFFEN MD PA BRUCE WHITING PH.D. *CAIRO EYE CARE CAPITAL RESEARCH INSTITUTE, INC. CARDIAC CLINIC OF SUNIL KAKKAR CARDIOLOGY AND INTERNAL MEDICINE GROUP - QUINCY CARDIOVASCULAR CONSULTANTS Carl Spirazza,D.O. CARLA HOLLOMAN DO CARLOS DANGER CARLOS M. MARTINEZ, M.D. Carmen Cornide,Psy.D. CARMEN TOZZO JULIAN PHD CAROL GRANT MD LLC Carol Walter Kaufman,Psy.D. CARRINGTON EVALUATION & BEHAVIOR SERV CARTER PSYCHOLOGY CENTER CAYLEIGH BENNY HARPER CECILIA YOCUM PHD CELEBRATION EYE CARE *CENTER FOR BEHAVIORAL HEALTH CARE P.A. CENTER FOR SPEECH & LANG CENTRAL FLA SPEECH & HEARING CENTRAL FLORIDA PREMIERE EYE ASSOCIATES CENTRAL FLORIDA THERAPY INC CENTURY CLINICAL FAMILY MEDICINE *CHAD HAGANS, PHD CHARLENE WESTMAN CHARLES MAITLAND MD CHRIS CATT, PSY.D CHRIS OKONKWO MD CHRISTIAN BERRIOS, PSYD CHRISTINE BECK-PALATKA *Ciceron V Lazo, M.D. CITRUS OPEN MRI CENTER *CLEAR SOUND AUDIOLOGY *CLEMENTS & ASSOCIATES PA CLEMENTS & ASSOCIATES, P.A. *Clifford Share, M.D. *COLLEEN CHARACTER, PH.D. COLUMBIA EYE ASSOCIATES - LIVE OAK COLUMBIA LAWNWOOD REGIONAL MEDICAL CT COMPLETE MEDICAL CARE ASSOCIATES, INC COMPLETE REHABILITATION FT WALTON BEACH: ERE CONSULTING PSYCHOLOGISTS OF S.FLORIDA, INC. COPELY EYE CLINIC CORNELIUS HALVEY MD **CORNERSTONE NEUROPSYCHOLOGY--ERE CORNERSTONE PEDIATRICS CRESCENT THERAPY AND ASSESSMENT CRISTIAN DEL RIO, PSY.D. *CROSS CREEK MEDICAL PA - TALLAHASSEE CYNTHIA HEISE D. P. Raju, M.D. DALE K JOHNS MD DANIEL L. WARD,PH.D. Daniel Pope MD DARBY L GODWIN, PHD DAVID A. YUDELL, PSY.D.,P.A. DAVID B RAWLINGS PH D P A DAVID BRODNER M.D. David Echavarria, Ph.D. DAVID J. FLEISCHMANN, PH.D. **DAVID KARPF PHD DAVID M KLEIN M D OPHTHALMOLOGIST PA DAVIS FAMILY HEARING DAVIS OPTOMETRY GROUP DEBORAH F SHULTZ MD *DENISE VERONES PHD Dennis D Dewey, M.D.

DEVELOPMENTAL BEHAVIORAL PEDIATRICS OF CENTRAL FL DFS WALK-IN CLINIC **DIANA BENTON PSYD - GAINESVILLE DIANE THEODORE M.Ed. **DISABILITY CONSULTANTS PC *DISABILITY CONSULTANTS PC DOCTORS IMAGING GROUP OF GAINESVILLE DOCTORS MEDICAL CENTER OF WALTON COUNTY PA DOCTORS MEMORIAL HOSPITAL DONALD A. STEWART, PSY.D. DONALD B KNAPP II MD DONALD J TINDALL MD Dorothy Lekarczyk Ph.D. DR LYNN R BERNSTEIN & ASSOC PA DR NANCY MACKAY E JACOB MD E MED URGENT AND PRIMARY CARE, PA EAR NOSE THROAT ASSOCIATES OF LAKE COUNTY PA EAR-TRONICS INC EAR-TRONICS INC Eduardo Sanchez M.D. *EFTIM ADHAMI MD ELIAS BANUELOS MD: ERE ELITE IMAGING GROUP ELLEN D SILKES MD PA ELLEN SUAREZ-PINZAS PSYD PA EMAD EISA EMERALD COAST AUDIOLOGY EMERALD COAST NECK AND BACK CLINIC ***EMERALD COAST PSYCHOLOGY SANTA ROSA BEACH

EMERALD COAST SPORTS MEDICINE AND ORTHOPAEDICS PA EMERGENCY MEDICAL CENTER EMPOWER PREVENTIVE MEDICINE PA - JACKSONVILLE ENID GILDAR MA CCC ENIOLA OWI MD ENT ASSOCIATES OF SOUTHWEST GEORGIA Ernst Nicolitz M.D. *ESHAN M KIBRIA DO Eugene Eisner MD EUGENE J. HERRMANN, PH.D. EVA GOYETTE, D.O. EXCEL PEDIATRICS EXODUS REHABILITATION INC EYE ASSOCIATES OF PINELLAS EYE CENTER SOUTH, PANAMA CITY EYE-I-DEALS *F DONALD KELLY PHD FAMILY MEDICAL CARE OF THE PALM BEACH FELICE CENTER FOR PEDIATRIC REHAB FELIX J SUBERVI III PHD *FIRST COAST HEARING CLINIC, INC.-PALM COAST FIRST COAST HEART & VASCULAR CENTER Flagler Hospital FLORIDA EYE ASSOCIATES INC FLORIDA EYE CLINIC FLORIDA HOSPITAL AUDIOLOGY FLORIDA HOSPITAL HEARTLAND FLORIDA HOSPITAL MEMORIAL DIVISION FLORIDA HOSPITAL SOUTH FLORIDA NEUROPSYCHOLOGY FLORIDA REHAB PROFESSIONALS GROUP, INC. *FLORIDA REHAB. PROFESSIONALS CENTRE, INC. Focus Imaging Group,Inc. FORT PIERCE FAMILY CARE INC FORT PIERCE VISION CARE FORT WALTON BEACH MEDICAL CENTER FRANK A BROWN PHD FRED L ALBERTS JR PHD *FUNDAMENTAL THERAPY SOLUTIONS (SPANISH EXAMS) GABRIEL YBARRA, PHD GARDNER AUDIOLOGY GARDNER AUDIOLOGY INVERNESS GARY HONICKMAN, PH.D. GENE TERREZZA OD **GEORGE SLADE MD GEORGE ZAKY PSYD GEORGE ZAKY, PSYD GHIATH KASHLAN MD GILLIOM AUDIOLOGY PA GLN SPEECH PATHOLOGY SVCS INC ***GNC THERAPIES INC **GNC THERAPIES PENSACOLA: ERE GNC THERAPIES, INC. GNC THERAPIES, INC. GOROVOY M.D. EYE SPECIALISTS GRADY GENERAL HOSPITAL GREGORY C MARONE PHD GREGORY C. LANDRUM, Psy.D. GROWING WELL FAMILY BEHAVIORAL SERVICES GUILLERMO SUAREZ MD GULF COAST VISION CENTER GULF MEDICAL CLINIC Harlan Chiron MD Harold Christopher Ward, D.O. Harold Friend MD HEALING EYE CARE HEALTH & WELLNESS PLACE INC HEALTH FIRST OCCUPATIONAL MEDICINE HEALTHPLEX FITNESS AND REHAB *HEALTHPSYCH ASSOCIATES, INC HEALTHPSYCH ASSOCIATES, INC. HEAR 4 KIDZ, INC. HEARING ASSOC OF CENTRAL FL HEARING ASSOCIATES OF PENSACOLA HEARING PARTNERS OF SOUTH FLORIDA HEARING SOLUTIONS INC - LAKE CITY HEATHER LASHER SLP-ORANGE CITY ***Hector Meruelo, M.D. HENRY A TENENBAUM PHD HIGHLANDS BREAST & IMAGING CENTER Hilda Besner, Ph.D. Hilda T Tejero MD HOMESTEAD HOSP PHYSICAL AND SPEECH THERAPY CTR. HOMI S COOPER MD **HOPE COUNSELING CENTERS *HOPE COUNSELING CENTERS-ERE **HOPE COUNSELING-ST AUGUSTINE HOPE, PANAMA CITY ***IMA EVALUATIONS, INC. IMA EVALUATIONS,INC. **INDEPENDENT EXAMINERS PENSACOLA **INDUSTRIAL MEDICINE ASSOCIATES PC INPSYCH CONSULTANTS,P.A. INTEGRATED THERAPY ALLIANCE, INC ISSAM AL-BANNA MD IVAN F. DANGER, PH.D. J OLIVER SPEECH PATHOLOGY *J. JEFF OATLEY, PH.D Jack R. Weitz, Ph.D. JACKSON COUNTY HOSPITAL JACKSONVILLE EYE CENTER Jacquelin Alexis,Ph.D. JAIME SUMNER MSCCC SLP **JAMES HENDERSON MD JAMES R BOONE PHD **JAMES R. SHOEMAKER, D.O. JAMES W. HOLBROOK, ED.D. Jamie H Barron Psy D JANE A. O'BRIEN, AUD.,CCC,F-AAA **JANET HUMPHREYS PHD - GAINESVILLE JAS MEDICAL MGT.,LLC JAY ROSENFELD, OD PA *JEAN FELERT CADET MD JEFFREY A HIRSCHFIELD MD JENNIFER AUTENRIETH SLP JENNIFER GOETTE JENNIFER MENDOZA PHD JEREMY N HARRIS MD *JET MEDICAL CENTER-SAMER CHOKSI, MD JMB SPEECH LANGUAGE PATHOLOGY SERVICES *JOHN DAWSON MD John E. Oshodi,Ph.D. JOHN J. CATANO,M.D. JOHN SWIFT MD John T Super PhD JONATHAN COHEN PHD Jose A. Bengochea,M.D. JOSE NADINE GARCON, PSY.D. JOSE PEREZ-ARCE MD JOSEPH HOLZMACHER PSYD Joseph Singer, M.D. Josette Jourdan.M.D. Juan Sanchez MD JUNE H BLAUSTEIN MS KAREN F. KUHNS, M.D. KAREN HAGEROTT KAREN KOZY-LANDRESS *KARL R WILLERS PHD *KATINA SHINE, PHD **KENNETH LONG PHD - TALLAHASSEE *KENNETH LONG, MARIANNA KENNETH VISSER PHD KERNAGHAN & MOORE SPEECH & LANGUAGE THERAPY KEVIN M. KINDELAN, PHD KHALIL A WALLIZADA MD KIDS FIRST THERAPY CENTER KID'S THERAPY UNLIMITED INC-ERE KIMBERLY WOOLDRIDGE, PSYD ***KLM MEDICAL SERVICES LLC KRZYSZTOF LEWANDOWSKI MD L. Earl Wingo, M.D. LAB CORP - TALLAHASSEE LABCORP LABCORP LABCORP - OCALA LABCORP - PENSACOLA LABORATORY CORP OF AMERICA LABORATORY CORPORATION OF AMERICA LABORATORY CORPORATION OF AMERICA LAKE CITY MEDICAL CENTER LAKELAND REGIONAL HEALTH *LANCE CHODOSH MD LAROCCA SPEECH THERAPY, INC. Laura A. Cohen,Ph.D. Laura M. Artiles,Ph.D. *LAUREN E. LUCAS, PH.D. Lawrence Goldberg MD *LAWRENCE N PASMAN PHD LEBOWITZ MEDICAL GROUP PA LEE MEMORIAL HEALTH SYSTEMS LESLIE ANN FRASER MS CCC SLP LETS TALK LIFE SOLUTIONS PSYCHOLOGICAL SERVICES, P.A. LINDA ABELES PHD **LINDA APPENFELDT PHD LINDA DELUCCA LINDA S BOJARSKI PSYD LISA M WININGS PSYD LORI BEN-EZRA, PH.D. LORI CHANG PHD Lourdes E. Pola,Ph.D. LUIS ANEZ, MD LUIS ZALDIVAR, PH.D. MABEL LOPEZ PHD MAHFOUZ EL SHAHAWY MD MAITLAND INTERNAL MEDICINE MAITLAND PRIMARY CARE MAJID A. SHAMS,PH.D.,P.A. Manuel Alvarez Ph.D MANUEL MELENDEZ, M.D., P.A MARGARET R. MORTENSEN, PH.D. MARIA ELENA RODRIGUEZ MARIA M. MENA, M.D. MARIA VAN SANT CCC SLP MARIBEL MERA PSYD MARIE BOURISQUOT, PSY.D. MARIE HUME GUILFORD PHD (TESTING) MARK REEVES PHD MARLA NADEL, SLP MARSHALL GLADNICK MD MARTIN D. SEGEL, PH.D.& ASSOCIATES,P.A. MARY CATHERINE SEGOTA PSYD MARY J.KING, D.O. MASINO--ERE MATTHEW J. JALAZO, PSY.D. MAUREEN OHARRA PHD MAURO, REYNOLDS, AND ASSOC. IN COUNSELLING, P.A. MAXINE A. SADHAI, PSY.D. MAXINE RUDDOCK PHD MAYLO COMPREHENSIVE PSYCHOLOGICAL SERVICES MAYRA M. MIRO, PSY.D. MCCARTHY PREVENTIVE SERVICES MCCOY INSTITUTE OF HEARING AND BALANCE **MDSI PHYSICIAN'S GROUP, INC. MED EYE ASSOCIATES **MED PLUS - ST. AUGUSTINE **MED PLUS DISABILITY EVALUATIONS MED PLUS FL **MED PLUS PENSACOLA MEDICAL BILLING SERVICES MEDICAL EYE ASSOCIATES MEDICAL SPECIALISTS OF THE PALM BEACHES, INC. MELBOURNE URGENT CARE LLC MELBOURNE VASCULAR CENTER MELITA DUFFY SLP MICHAEL BREGLIA, MD MICHAEL DRUCKER MD MICHAEL P INMAN, PHD MICHAEL RAILEY PHD - TALLAHASSEE MICHAEL S. GREENBERG PH.D. MICHAEL SIMPSON,PH.D. MIGUEL FLORES,M.D. MILAURA B SPELMAN CCC-SLP Mirentxu Leiva,Psy.D. MIRTHA E. CUEVAS, M.D., INC. MOHAMMAD YUNUS **MOONLIGHT EXAMS (XRAY) Morton S. Corin,M.D. MOSAIC PSYCH-ST AUGUSTINE MP DIAGNOSTIC LTD MULTI LINGUAL SPEECH GROUP INC MULTILINGUAL PSYCHOLOGICAL SERVICES LLC MUNROE REGIONAL MEDICAL CENTER *MURALI KRISHNA MADDIPATI: ERE MY EYE DR OPTOMETRY OF FLORIDA LLC MY EYE DR OPTOMETRY OF FLORIDA LLC N FLA REGIONAL MEDICAL CENTER *N KIRMANI MD-DELAND NAPLES COMMUNITY HOSPITAL NATURES PLACE THERAPY SERVICES NEKESHIA HAMMOND PSYD PA NEUROLOGIC CARE CENTER PA NEUROPSYCHIATRIC INSTITUTE NEUROPSYCHOLOGICAL & COUNSELING SERV. NEURO-REHAB PSYCHOLOGY GROUP OF TAMPA NEUROSCIENCE CONSULTANTS NEW PATH PSYC-SANDRIK *NEWSOME MEDICAL LLC NICOLE HITE *NINA M BARNES PHD NLSA M MARBAN PSY.D NORTH ARMENIA MEDICAL CENTER NORTH BROWARD NEUROLOGY NORTH FLORIDA HEARING AND BALANCE - LAKE CITY NORTH FLORIDA PSYCHOLOGICAL SERVICES *NORTH FLORIDA THERAPY ASSOCIATES, LLC NORTH OKALOOSA MEDICAL CENTER NORTHSIDE MEDICAL CENTER NW FL COMMUNITY HOSPITAL **NYDIA CONRAD PSYD-ERE OCALA EAR NOSE AND THROAT SPECIALISTS Occupational Medical Center OCEAN OPTICAL OMNI MEDICAL CLINIC ORANGE PARK AUDIOLOGY ORTHO CENTER OF OKEECHOBEE OSAMA ELSHAZLY MD PALM BEACH PSYCHOLOGY GROUP LLC PAMELA ROWE MA CCC SLP LLC PAMELA ROWE SLP-OCALA PAMELA ROWE, MA, CCC-SLP PARAGON PSYCHOLOGICAL SERVICES CORP PASCAL BORDY MD PASCO EYE INSTITUTE **PATRICIA HARRISON MS CCC PATRICIA SHELLY LOHMAN PATRICK KANE, MD PATRICK M. GONZALEZ, M.D. Paul J. Goldberg, M. D. PAUL TRITSOS: ERE PEDIATRIC THERAPY/KIDS TALK - PENSACOLA PEDIATRICS PLUS PEREZ EYE CENTER PL PETER BURSTEN PH.D. ***PETER KNOX,PSYD-DOWNTOWN PETER MILLHEISER, M.D, PETER S LARKIN *PHILIP JAMES DUBOSE JR PSYD PHYSIATRIC PAIN & MEDICAL REHAB CLINIC PHYSICAL MEDICINE & REHAB CENTER PHYSICIAN'S CHOICE HEARING & DIZZINESS CENTER PHYSICIANS STAT LAB INC PIERRE-RICHARD EDOUARD, M.D. POMPANO BEACH PSYCHOLOGICAL SERVICES PREFERRED PSYCH SERVICES *PREMIER MEDICAL CLINIC PRESTIGE CARDIOLOGY PRIMARY CARE CENTER PRN SPEECH PATHOLOGISTS PRN SPEECH PATHOLOGISTS PSYCH ASSOCIATES **PSYCH INC - LAKE CITY *PSYCH INC-PALATKA PSYCHOLOGICAL & NEUROBEHAVIORAL ASSOC PSYCHOLOGICAL SERVICES-DR MILNE *PULLEN EYE CARE *PUTNAM FAMILY CARE INC PUTNAM RADIOLOGY QUALITY MEDICAL PERSONNEL,INC. QUINN EYE CENTER **R CRAIG NIELSEN MD R THAD GOODWIN MD RADIOLOGY & IMAGING SPECIALISTS RADIOLOGY ASSOC OF VENICE RADIOLOGY ASSOCIATES OF TALLAHASSEE PA RADIOLOGY REGIONAL CENTER RAHEEL AHMED MD RAJAN SAREEN MD RANDI MOST PHD Randy Levine,Ph.D. RATHINAM KRISHNA MOORTHY, MD RAUL ZELAYA MD RAYMOND F BARNES MD RAYMOND MCKNIGHT, M.D. *REBECCA WAMBOLT - TALLAHASSEE *REGIONAL THERAPY SERVICES INC - VALDOSTA REHABILITATION PHYSICIANS Rene Rocha,Ph.D. RG THERAPY SERVICES INC RICHARD GLOSSER M.D. RICHARD L BELSHAM PHD Richard Reines, M.D. RICHARD S. KALSKI, M.D. Richard Sandrow, M.D. RICHARD SASSATELLI, PH.D. ROBERT E. SEIFER,PH.D.,P.A. *ROBERT GREENBERG MD ***ROBERT KLINE PSYD - TALLAHASSEE (MSE ONLY) ROBERT M JAEGER DO ROBERT M. MANDELKORN, MD Robert Martinez MD ROBERT MOERING PSYD ROBIN HUGHES MD *ROBIN JOHNSON, PSYD RODERICK SANTA MARIA D.O. ROGER L. BASH, PH.D. ROGER N ARUMUGAM MD ROJEANNE JEAN, PH.D. ROLAND D. KAPLAN,D.O. RONALD SEIFER,PH.D.,P.A. ROSE RADIOLOGY CENTERS, INC. ROYCE N. JALAZO, PSY.D. SACRED HEART CARDIOLOGY SACRED HEART HEALTH SYSTEMS SAM BANNER MD SAM RANGANATHAN, M.D. SAMEH M. ELAMIR, MD SANTA ROSA MEDICAL CENTER SARASOTA CHILDREN'S CLINIC Sarasota Memorial Hospital SAY IT PLEASE, INC. SCOTT L GELLER MD SCOTT M KAPLAN PSYD SCOTT WELSH SEIDMAN ASSOCIATES IN BEHAVIORAL COUNSELING Seth D.Leventhal,Ph.D. Shahab Kidwai MD **SHANLIS INC SHARAD VYAS MD SHERYL FERGUSON, PSY.D. SHORELINE PSYCHOLOGICAL SERVICES, LLC **SILVER STAR FAMILY MEDICINE *SIMPLY SPEAKING, LLC SMALL STEPS PEDICATRIC THERAPY INC *SMALL TALK-ST AUGUSTINE SOCRATES PEREZ-RODRIGUEZ MD, PA SOUTH FLORIDA ENT SOUTH FLORIDA ENT ASSOCIATES South Miami Audiology Consultants *SOUTHEASTERN THERAPY SERVICES LLC SOUTHSHORE BILINGUAL SLP SERVICES SOUTHWEST FL CENTER FOR HEARING AND BALANCE SPEAK EASY SOLUTIONS LLC SPECIALIZED SPEECH CENTER,INC. SPEECH & NEUROREHAB CENTER INC SPEECH AND LANGUAGE CENTER *SPEECH WORKS-PALM COAST SPEECHBUILDERS LLC ST LUCIE EYE ASSOCIATES *ST VINCENTS FIRST CARE-ROOSEVELT ST VINCENTS LUNG SLEEP & CRITIAL CARE SPEC St Vincents Medical Center STACY B. MELTZER, M.S.,CCC-SLP STANFORD ANTHONY WILLIAMSON/P D E S STEP BY STEP THERAPY *STEP N STONES SPEECH THERAPY STEPHANIE CASTIGLIA PSY D STEPHEN I HIRSCHORN PHD STEPHEN TONER MD STEVE KANAKIS PSYD **STEVE ODEH MD - FT WALTON BEACH **STEVE ODEH MD - THOMASVILLE STEVEN E. O'NEAL STEVEN L. KANNER, D.O. STEVEN MINTER, PSYD STEVEN WU PHD STUART BERNSTEIN SUMA WELLNESS CENTER SUNCOAST THERAPY SUNRISE MEDICAL GROUP SUSAN DANAHY PHD SUSAN SHONBRUN, SLP SUSAN SULLIVAN PHD *SUSANA BARSKY PHD SUSANA LOZADA-MURRAY, PSY D, LLC SYED GILANI MD SYLVESTER AJUFO MD TALLAHASSEE ENT HEAD AND NECK SURGERY TALLAHASSEE MEMORIAL - VISUAL EVOKED POTENTIAL TAMPA BAY ENT AND COSMETIC SURGERY PA TAMPA BAY PULMONARYMEDICINE, PA Tampa Eye Clinic *TARGET TESTING TED B. CUNLIFFE PH.D. LLC THE CENTER FOR HEARING AND COMMUNICATION THE FOCAL POINTE THE HEARING CENTER THE LUNG CLINIC *THERAPEUTIC ENDEAVORS THERAPY ASSOCIATES OF GEORGIA THERAPY ASSOCIATES OF SOUTH FLA., INC. THERAPY ESSENTIALS INC THOMAS A DIGERONIMO MD PA THOMAS F BEAMAN DO THOMAS F GUIDERA PHD THOMAS G TRIMMER PH D INCORPORATED TIMOTHY FOSTER PHD LLC TOMOKA MEDICAL LAB INC TOPS REHAB TOUCHSTONE IMAGING OF PENSACOLA TOULA MCGINLEY, INC TOWNSEND&ASSOC-PALATKA Traci Seidman,Ph.D. TRI-CITY WALK-IN CLINIC TRINITY BEHAVIORAL HEALTHCARE TURNING POINT CENTER FOR PSYCH & FAMILY GROWTH *U.S. HEALTHWORKS MEDICAL GROUP - OCALA UMESH MHATRE MD ***UNIVERSITY MEDICAL HEALTH CENTER UNIVERSITY PEDIATRIC CENTER,INC. URGENT CARE USA *US HEALTHWORKS MEDICAL GROUP US HEALTHWORKS MEDICAL GROUP-ORANGE USE YOUR WORDS PEDIATRIC SPEECH THERAPY, INC. V SAMANTHA LINDMEIER PSY VAIDY V NATHAN MD VERO ENT ASSOCIATES VERO RADIOLOGY VICTORIA TE MD VINCENT IVERS MD *VIRGINIA DIXON-WOOD SLP (GAINESVILLE-B) Vivian Gonzalez-Diaz,Ph.D. **VIVIAN ROY PHD *W. Nicholson Ainsworth, IV, M.D. *WAKULLA URGENT CARE WELCH & MCLOY THERAPY SERVICES WEST BOYNTON BEACH OPEN IMAGING CENTER,LLC WEST COAST MUSCULOSKELETAL INSTITUTE WEST COAST MUSCULOSKELETAL-HOMASASSA *WEST FLORIDA MEDICAL GROUP WEST HERNANDO DIAGNOSTIC CTR WEST PALM BEACH NEUROLOGY PA WHITE WILSON MEDICAL CENTER WHITING PEDIATRIC THERAPY *WILLIAM BEATY PHD William Beecham,Ph.D. *WILLIAM BENET PHD PSYD WILLIAM ERHARD EYRING III PSYD WILLIAM HULLEY DO William J. Oktavec M.D. William V. Choisser, M.D. WINTER HAVEN HOSPITAL YOUNT PSYCHOLOGICAL SERVICES PLLC

Georgia FY 2017

Onsite visits Last Name First Nm Credential Office Name completed Key/Reason Removal from panel Adams-Pelham Kristin PSY Agarwal Mukesh MD Satilla Family Medicine PC Agarwal Nishi MD Satilla Family Medicine PC Ajayi Julius MD First Foundation Medical Clinic PC Akinsola Adebayo MD Baybol Pediatrics LLC Al-Amin Jessie Louise Muse MD volume $150K Albritton Mary Kennedy SLP Greater Atlanta Speech & Language Clinic Inc Alford Kimberly Brown SLP Communication Partners Allen Belinda PT Regional Therapy Services Inc Allen Steve PT Regional Therapy Services Inc Allen Dawn M PhD key primary CE Allen Robert S AUD Hearing Doctors of Georgia Allen Ana Maria SLP Ameritherapy Allen, Jr Robert S AUD Hearing Doctors of Georgia Allsopp Ralph N PhD United Psychology Center Anderson Larry DO Northside Primary Care Professional Services Andrews John S MD Ansine Sarah SLP Kidspeech Inc Arkin Lawrence Michael MD Arrington Gertrude MD Kids Avenue Pediatrics LLC Ashby Stacy Aileen AUD ENT Associates of Columbus PC Ashraf Khuram RP Med Plus Disability Evaluations Inc volume $150K Atkins Jennifer MD Atkins Consulting Atkinson Tameshia SLP Words & Beyond Speech Therapy Services LLC (b) (6) Ayeni Oluropo Alfred MD Wellspring Medical Center key primary CE Ayers Ashley Anthony SLP The Therapy Spot (b) (6) Bailey David S PhD Baker Melody U SLP Regional Therapy Services Inc Ball Kelly J SLP Therapy Solution of Georgia Inc Baloch Faryal MD East Metro Rheumatology LLC Bank Richard PhD Bank Psychology Banner Sammy MD Bari Abdul MD Barnhill Magan Thomas SLP The Speech Clinic LLC Barrell Kelly Amanda SLP Palmetto Speech & Language Baskett Laura Colleen AUD Hearing Doctors of Georgia Battey Amanda Stephens AUD Bayyapureddy Priya Vamsi MD Northside Primary Care Porofessional Services key primary CE Beasley Ellen Collier SLP ABC Pediatrics Therapy Partners Inc Beldick Gary A MD Bell Canady Christina Dawn SLP More Than Words Benedict Alan MD Georgia Eye Specialists Benefiled Kimberly B SLP Kidspeech Inc Bennett-Johnson Dianne MD Appointed Physicians Inc Bennett-Sims Melanie Ann MD Carlin Vision Berger Steven PhD Berger Psychological Services PC volume $150K Berry Garland Keith MD Carrollton Eye Clinic PC Berryhill Nancy Gunn SLP The Voice Box LLC Berry-Sawyer Kim PhD Med & PSY Associates Inc Besses Valerie PhD Intown Psychological Associates volume $150K Beverly James OPT Bingham Janelle E SLP Lets Talk Therapy (b) (6) Blakeman Rebecca S PhD Adolescent Child Specialty Services Bluver Meredith Eden SLP Greater Atlanta Speech & Language Clinic Inc Bohannon Edgar Robin AUD Augusta Hearing & Balance Bonas Katherine Claire SLP Kidspeech Inc Born Ashley SLP Kidspeech Inc (b) (6) Boswell Andrea Nestor SLP Bouy Renee L SLP Kidspeech Inc Bowman Caroline Ursrey SLP The Therapy Spot Bowman Carolin Ursrey SLP The Therapy Spot Boyd Stephanie PhD Family Forward LLC (b) (6) Brikman Alexander PhD volume $150K Brown Regina S PhD Transitions Psychological & Consultative Services LLC (b) (6) Brown Reginald MD key primary CE Brown Adam MD Med Plus Disability Evaluations Inc volume $150K Brown Crystal Lynn Singlet MD Brown Family Practice LLC Brown Katherine D SLP Greater Atlanta Speech & Language Clinic Inc Browne Gloria MD Roman Medical Group (b) (6) Bruckner Howard L MD Academy of Cataract & Laser Surgery PC Bryan Tammara G PhD (b) (6) Bryant Leah SLP Kidspeech Inc Buddington Roger PhD Buddington Psychology Clinic PC Burger Richard MD Southern Medical Group (b) (6) Burnham Trisha Marie SLP Looper Speech & Hearing Cebter (b) (6) Butler Chandra Elis SLP Divine Speech Language Service Inc Butryn Matt PhD Athens Neuropsychological & Counseling Byrd Tameka OD Med Plus Disability Evaluations Inc volume $150K Cain Alicia MD Canady Leigh Blackburn SLP Leigh Blackburn Communication Station Cannon Sterling Lane MD West Georgia Eye Care Center Canup Marina Bilbao SLP ABC Pediatrics Therapy Partners Inc Carden Nick PhD The Renaissance Centre key primary CE Carey Danielle E SLP The Therapy Spot Carter Kricket Nicole SLP The Language Learning Center Carter Stefani SLP Communicative Solutions Group Inc Carter-Richardson Tamara J SLP Communications Solutions Group Inc Castleberry Leigh SLP Kidspeech Inc Caye David MS Cerjan Diane PhD Journey Counseling & Psychological Chadwick Brian Stephen MD Alta Medical Consulting Services LLC volume $150K Chalam (Arunachalam) Krishnan MD Chaplin Ursula AUD Chattanooga Hamilton Co Speech & Hearing Center Chapman Rees PhD Chappell Nondi C SLP Clear Speech LLC (b) (6) Charest Tamara SLP Communication Partners Inc Chopra Hersh MD Georgia Eye Specialists Clancy Priscilla Wilson PhD Leading Edge Consulting Group Clark (Coleman-Clark) Lilee (Carroll) PhD Georgia Developmental Center Cleary Kelly DO Prchal & Prchal PC Cleveland Langston MD Worksmart Occupational Health Colegrove Eric William OPT Habersham Eye Clinic Coleman Angela Horne MD Tri-State Occupational Medicine volume $150K (b) (6) Collins Kimberly Jill SLP Growing Communication Inc Cone Linsey Marie SLP Regional Therapy Services Inc Connell Robert PhD Cooper Adrienne Jenne SLP Looper Speech & Hearing Cooper Scott David MD Medical Associates Professional Services LLC Copes Kristen SLP The Speech Key Inc Corey William F PhD Courtenay Clifford OPT Eye Associates of South Georgia Courtney Audrey PhD Crocker Bobby Anderson MD Goodlife Family Practice PC Crosby Lisa G SLP Greater Atlanta Speech & Language Clinic Inc Crumbley Christian SLP Regional Therapy Services (b) (6) Crymes Brent Michael MD Athens Eye Dr & Surgeons Culmer Ashley SLP Lets Talk Therapy Curry Alicia Joneka SLP Clear Speech LLC (b) (6) Davis Adrienne PhD Davis Nicholas Jerome OPT Braun Eyecare (Bruce L Johnson Inc) Davis Gavin MD Augusta Eye Davis Jennifer Diane AUD Hearing Associates PC (b) (6) Davis Matthew Edwin MD Davis Carly Marie SLP PediaSpeech Services Deen K Murray MD Upson Eye Clinic Degroot James F PhD United Psychology Center Delancy Dara Ann PhD Family Forward LLC Dellenbarger Leslie Ann PhD Flint River Therapy Associates Inc DeLoach Ralph, III SLP Therapy Solution of Georgia Inc Denes Gabriel PhD Counseling Psychology Associates LLC Desai Saurabh D MD Douglas Medical Group Dinges David Lee MD Dalton ENT Associates PC (b) (6) Dismuke Tinika Danyelle SLP Step N Stones Speech Language Services Dixon Terri Chiquita SLP Speech Therapy Unlimited Services Dixon-Martin Kelly Ann MD St Marys Industrial Medicine Doman Alexander MD S Atlanta Orthopaedics & Sports Medicine PC Doster Lenore PhD Barnesville / Newnan Services Dubose Jr Philip Janes PhD Psychological Center volume $150K Duncan Scott PhD key primary CE Dyer Divina N MD DG Medical Consultant LLC Eady Lisa J SLP Communication Partners Inc Eanes Mark MD Southern Eye Center PC Eaton Marc W PhD key primary CE Ebron Marian MD (b) (6) Echols Melanie PhD Lifespan Psychological Services Edwards Kathleen Ann Lane SLP Looper Speech & Hearing Center Eggert Ann Elizabeth MD Peachtree Pediatrics PC Elkan Mindy SLP Greater Atlanta Speech & Language Clinic Inc Eltarawy Islam MD Piedmont Physicians Group at East Ellijay Fainberg Jolie Carin AUD Atl Speech School Farr Chastity Nicole PhD Newnan Psychological Services Inc Fayne Ashia Nicole SLP Lets Talk Therapy Feit Madyson Anne SLP Therapy Solution of Georgia Inc Ferguson Margaret SLP Ameritherapy Fernando Marylou MD Fesler Kellie Morgan SLP Regional Therapy Services Finley Katherine Jan PhD Athens Concussion & Neuropsychological Center Fischer Suzanne PhD Psychological Associates of NW Georgia Inc Fleitas Donna PhD My PSY LLC Fomukong Mah-Fri Akere MD Med Plus Disability Evaluations Inc volume $150K (b) (6) Ford Ashley Nicole SLP Communicative Solutions Group Inc Forrest John Wendell MD Forrest Eye Center Foster Prima MD Capri Medical Group Foster III Robert A PhD Fraser Fred D PhD Frazer Anesha SLP Atlanta Speech Therapy (b) (6) Frederickson Edward Dent MD Mountain Medical Specialties Inc (b) (6) Fried Jeffrey MD Futral Heather PhD Gadlin Scotty MD Athens Eye Associates Gamble Nacondus OD South Eastern Eye Center Ganas Jennifer SLP Rehab Services of Tifton Gandy-Walker Paris PhD New Day Psychological Services LLC (b) (6) Gardner Beau MD Eye Physicians & Surgeons of Augusta PC Gayer Harvey PhD Positive Outcome Psychological Services PC Gentry Lisa Lovern SLP Kidspeech Inc Gibbs Nakita SLP Communicate to Connect Therapy Giffen Devorah PhD Academy Psychological Services Inc Goble Jennifer JE SLP Greater Atlanta Speech & Language Clinic Inc Goddard John MD Carrollton Eye Clinic PC Goetzinger Robert MD Gomez Robert F MD Gonzalez Karen SLP Braun Eyecare (Bruce L Johnson Inc) Gordon Daniel Harry MD Live Well Medical Consultants key primary CE (b) (6) Gordon Jenny L SLP Communication Partners Inc Gottlieb Dvora Posner SLP Savannah Speecy & Hearing Grace John PhD Grace Psychotherapy key primary CE Graham Jannie Gail SLP Communication Dynamics (b) (6) Graham Robert MD Med Plus Disability Evaluations Inc volume $150K Grant Bruce Nicholas PhD Discovery Counseling Assessment Center LLC Grant Cathryn B AUD Harbin Clinic LLC Green Roland MD Alta Medical Consulting Services LLC volume $150K (b) (6) Greene Mathew OPT Regional Eye Center Greene Alton MD Med Plus Disability Evaluations Inc volume $150K Gregg Stephanie A SLP Therapy Solution of Georgia Inc Griner Nancy MD ENT Snellville Gross-Barlow Lucinda SLP The Language Learning Center Inc Guerin Chelsea Rebecca SLP Kidspeech Inc Gustafson Leland Mark MD Carrollton ENT PC Hall Kristin Rowsey SLP Kidspeech Inc Haluka Lance OPT Southern Eye Center Hamby Charles Stephen PhD volume $150K Hankla James Waide AUD Hearcare Audiology Hannon Rachel Lea SLP Kidspeech Inc Harper William OPT Prchal & Prchal PC Harper Ginger Archer SLP Communication Partners Harper Hogan Cathy Lorraine MD Harrington Rosiland MD Decatur Medical Weight Loss LLC Harris Charles MD Southern Retina LLC Harris Duane PhD Harris Jacqueline MD Med Plus Disability Evaluations Inc volume $150K Harris-Davis Vonnia Lynett SLP Communications Solutions Group Inc Harry Lois MD Med Plus Disability Evaluations Inc volume $150K (b) (6) Hart-Moreland Santrell OPT East Lake Eye Care Hartzell Arthur PhD Arthur W Hartzell PhD PC Haynes Andrea MD Tri-State Occupational Medicine volume $150K Herrin Allison Callaway SLP The Speech Clinic LLC Hicks Melissa M PhD Communication Partners Inc Hicks Michele Harrison SLP Communication Partners Inc Highbaugh Battle Angela MD Hazlehurst Pediatrics PC Hinkley Ingrid Dawn SLP Hobdy Lindsey Shiver SLP Ameritherapy Hodges Edith McElheney SLP Ameritherapy Hoffman Margaret N SLP Greater Atlanta Speech & Language Clinic Inc Hoghart Jiovanne AUD Hearing Doctors of Georgia Holme Robert J MD Tifton Ophihalmology Holoyda Basil MD Neurology Associates LLP Holsten Amy Welch PhD Family Forward LLC Hope Donna SLP (b) (6) Hosterman Pamela Sue SLP Chattanooga Hamilton Co Speech & Hearing Center Howard Jamie Marie AUD St Francis ENT Howell Sarah PhD (b) (6) Huddleston Heather Alise SLP Regional Therapy Services Inc Hudson Mary Ann SLP Phenix Speech Language Services Inc Hughart Jiovanne AUD Hearing Doctors of Georgia Humayun Naseer MD Pulmonary & Sleep Medicie Hunter Candace PhD Atlanta Veuro Center LLC (b) (6) Huthwaite Justin PhD Justin S Huthwaite PsyD PC volume $150K Irons Daniel Anthony MD Jackson Demetria Larell SLP (b) (6) Jacobs Ann PhD SE Psychological & Counseling Services LLC James Robysina Louise MD Orthopedic IME Specialists LLC Janit Adrian PhD volume $150K Jeannot Michael MD Walton Pulmonary & Sleep Medicine PC Jelks Kim Willard MD Palmetto Health Council Inc Johnson Katherine F OPT Vidalia Eye Associates Johnson Eric MD Athens Eye Dr & Surgeons Johnson Bruce Lee OPT Braun Eyecare (Bruce L Johnson Inc) Johnson Kenia PhD Sweetwater Psychological Associates LLC Johnson John MD West Atlanta Internal Medical Joiner Bret PT Therapy South Jones Jennifer Lynn SLP Therapeutic Interventions of Georgia Jones Jonathan PT Regional Therapy Services Inc Jones Mandisa PT Jones PT Physical Therapy & Physical Training Jones Cristina SLP Lets Talk Therapy Jones Angela M SLP Linguistic Impressions Therapeutic Services Jones Sarah Elisabeth SLP Kidspeech Inc Jovovic Lauren Hudson SLP Ameritherapy June Patricia MD Kachra Dilshad SLP Lets Talk Therapy Kanchrala Ashok Kumar MD Reddy Medical Group Kang Young MD Kaplan Holly S AUD UGA School Psychology Clinic Karaseivich George PhD Hamilton Medical Center Karikaran Nilanee MD Headache & Neurological Care Center Katz Michael MD Med Ability Inc Keller Deborah Beth SLP Communication Partners Kenney Nicole Elizabeth SLP The Therapy Spot Kent Donald C PhD Kent Joan H PhD Ketisch Tanja PSY Mind Balance Psychology Center, LLC Khade John MD Med Plus Disability Evaluations Inc volume $150K Kias Thomas Nelson MD Kidwai Asim MD Piedmont Physicians Group at E Ellijay Kieran Rachel A PhD Kim Dooho MD Professional Eye Associates Inc Kimbrell Bart Wade MD Southern Medical Group Kington Ginny PhD Kini Ganesh MD Rockdale Physician Prac LLC - Primier Healthcare Alliance Kirkpatrick Sarah Lindsey SLP Clear Speech LLC Kitchens Wentzelle MD Washington County Internal Medicine PC Kolanu Raghuram MD Neurology South Korey Alesya PhD Kothari Ajay MD Kozinn Mark MD Atlanta Neuroscience Associates LLC Krichever-Federowicz Maria MD Live Well Medical Consultants key primary CE Kriete Kara SLP GNC Therapies Inc (b) (6) Krone Howard Barry MD Kruse Roberta J SLP Therapeutic Interventions of Georgia Kulkarni Vasudev Venkatrao MD East Dublin Urgent Care Center (b) (6) Kurl Ravinder Kumar MD Henry Internal Medicine Kuttappan Muthu MD Rockdale Physician Prac LLC - Primier Healthcare Alliance Labossiere- Hughley Tania SLP Communicative Solutions Group Inc LaCayo Juan MD Alcovy Neurology PC Lacount LaShonya Shamice SLP Precious Minds Academy LLC LaFerriere Lorraine Louise PhD (b) (6) Lagunas Maribel SLP The Speech & Hearing Center Lambert Julie G AUD Albany ENT & Allergy Clinic (b) (6) Langhorne Sheredia D SLP Communicative Solutions Group Inc Lanier Amy Rogers SLP Communication Partners (b) (6) Lanier Lea Batten SLP The Therapy Spot Latham Carrie Smith SLP Kidspeech Inc Leak Emily SLP Communication Partners Lebow Lori Charlotte OP Gainesville Eye Associates LLC Lee Norman PhD North Atlanta Neuropsychology LLC Lee Tiffany Charisse MD Priority Health LLC Leonard Julia Ashley SLP Kidspeech Inc (b) (6) Lewis Debra M PhD volume $150K Lieberman Lewis PhD Livingston Rita MD Live-Well Medical Consultants LLC key primary CE Lobel Steven MD Etowah Regional Medical Services PC (b) (6) Lockhart Ricky MD Middle Georgia ENT Center PC Logan James Robert MD Candler ENT Practice LLC Lopez Wandamarie PhD Better Mood Clinic PC Loverde Stacy Elise SLP Kidspeech Inc Lynes Michelle Lindsey SLP Savannah Speech & Hearing Center Maddox Samuel PhD A Healig Paradigm LLC Mahmood Khawaja MD Maierhofer Richard A PhD Maierhofer & Associates PC Maley Michael MD Malia Van Lee MD (b) (6) Maloy Jodi Nicole SLP Speech & Swallowing Clinic Mancil Twyla Lucinda PhD Psych Inc Mann Christopher Jay OD Athens ENT & Allergy Clinic (b) (6) Mannel Robert K MD Southern Medical Group Marti Michael PhD Thrive Works LLC (b) (6) Massie Sean PhD (b) (6) Mawhinney Katherine Holt AUD Ear Nose & Throat Associates PC Maya Sakib MD Alta Medical Consulting Services LLC volume $150K McAdams Valerie PhD McAdams Psychological & Consulting Service McCloud Mark Allen SLP Total Communication Services McClure Floyd Dale R SLP The Speech Key Inc McCullough Jennifer Lee SLP Pedia Speech Services McDonald Daniel PhD McDonald Melvenia SLP McElroy Teresa Lynn SLP Speech & Swallowing Clinic McGlamry Macey DeAnne SLP Regional Therapy Services Inc Mcintosh Elizabeth Fogarty SLP Savannah Speecy & Hearing Center McManus Kari Huffstatler SLP GNC Therapies Inc (b) (6) McQueenery David PhD Monarch Behavioral Health Inc Meck Donald PhD Mehta Vinod C MD Mercer Cassie Itaska SLP Merchan Joy Caroline SLP Millen James L. MD GA Internal Med Miller Mesa Sashea SLP Communication Dynamics (b) (6) Mixson John OPT Regional Eye Center Moates Kenneth OPT Regional Eye Center Moates Valerie OPT Regional Eye Center Mobley Michael MD Psychiatric Medicine PC Moeller Jessica Lee SLP Lets Talk Therapy (b) (6) Moody Julie E SLP Therapy Solution of Georgia Inc Moogerfeld Maria MD Moore Anne B PhD United Psychology Center Moore Chelse M SLP Divine Speech Language Service Inc Moorman Larry R MD Tifton Ophihalmology Morgan Jr Sidney MD Optim Health Care Moriarty Dawn M SLP Morin Hannah E SLP Communication Partners Inc Morris Carly Rae SLP PediaSpeech Services (b) (6) Mottwala Shabbir MD Moynihan-Greenberg Rita Michelle SLP Kidspeech Inc Mullady Thomas MD Chattanooga Diagnostic Associates LLC Muller John S PhD Evaluation Systems Inc volume $150K Murray Darrell Lee MD NW Georgia Psychological Associates LLC Nagy Karen W SLP Sunshine Speech Therapy Services Nariani Sanjay MD Jay Medical & Rehab Works PC Neal Kenneth David PhD Riverstone MD PC (b) (6) Needle Michelle Elyse SLP Greater Atlanta Speech & Language Clinic Inc Nelson Catherine Ann SLP Savannah Speech & Hearing Nelson Keanna M SLP Speech Assessment Center Inc Newman Phillip MD Center for Sight Ngu Julius N. MD Tri-State Occupational Medicine volume $150K (b) (6) Ngumba-Gatabaki Eunice Wanjiru PhD ORI ALAAFIA Coaching & Psychotherapy LLC Nix Cynthia MD West Georgia Eye Care Center Norwood Melvina PhD Just A Journey Counseling & Psychological Services (b) (6) O'Boyle Timothy MD Professional Eye Associates Inc Odeh Steve MD Heritage Health Care Services LLC volume $150K Odunbaku Amudalat A SLP Lets Talk Therapy O'Halloran Carolyn M SLP Kidspeech Inc Ojelade Ifetayo I PhD A Healing Paradigm LLC volume $150K Okoro Casimir Chukwumeka MD Southside Internal Medicine PC Okoro Obioha Louis MD Central Georgia Pediatric Inc Olson David MD DeKalb Neurology Group LLC Onyeabor Onyekachi MD Tri-State Occupational Medicine volume $150K Owensby Amber Pryor SLP Communication Partners Pack David K MD Metro Rehabilitatio Medicie & Acupuncture Clinic PC Painter Jill Challenger SLP Therapeutic Interventions of Georgia Pappoas Stephen MD Neuro Spinal & Headache Center Parikh Chirag MD Eye Care of Georgia LLC Parker Kenneth C AUD Audiology Services of Chattanooga Inc Parker Trina MD Roman Medical Group (b) (6) Parks William PhD Patel Ami MD Alta Medical Consulting Services LLC volume $150K Patel Ateeqahmed MD Med Plus Disability Evaluations Inc volume $150K Patel Natvarlal MD Patel Nipun MD Premier Family Clinic Patel Arvind Rambhai MD Patterson Emory MD Athens Eye Dr & Surgeons Paulk Whitney Lauren SLP Ameritherapy Peacock Lamar Bonner MD GA Internal Med Perez Tracy Alexander SLP Therapy Solution of Georgia Inc Peterson Laurie SLP Communication Partners Inc Pezold John Christopher MD Carrollton ENT PC Pharis Donna Marie SLP Kidspeech Inc (b) (6) Piquette Ashley S SLP Communication Partners Piros Judith M. MD Georgia Eye Institute of The Southeast Pitts Robert Brian MD Carrollton ENT PC Pompey Michael O MD Tri-State Occupational Medicine volume $150K Pope Myra MD JC Lewis Primary Health Care Center Prchal Gerald OPT Prchal & Prchal PC Prchal Joseph OPT Prchal & Prchal PC Pritchett Joy W AUD Hearing Associates PC Pruitt Helki C SLP Kidspeech Inc (b) (6) Rangaraj Ragesh Ramalingam OPT Kura LLL Rao Kalpana PhD Horizons Behavioral Health Solutions Rapillard Sarah Waters SLP The Therapy Spot Ray James MD Ray Clinic PC Rector Rebecca Ellen SLP ABC Pediatrics Therapy Partners Inc Reddy Ram MD Reddy Medical Group Reddy Chelukala MD Reeves Joseph MD Georgia Eye Institute of Savannah Reticker Aleyda D SLP Comm. Solutions Group Rich Michele SLP Childrens Therapy Group Inc Richardson Sheana A AUD Savannah Speech & Hearing Center (b) (6) Riney Charles Timothy PhD Newnan Services Rinow Michael Edward MD Pulmonary Diagnostic Testing Rittenhouse Lance OPT Stay Focused Eyecare Robbins-Brinson Larmia PhD Roman Charles Paul DO Roman Medical Group (b) (6) Rose Michael PhD volume $150K Roth Kristiansson PhD volume $150K Roy Deanna Lynne MD Med Plus Disability Evaluations Inc volume $150K

Ruble Paul Spencer DO (b) (6) Med Plus Disability Evaluations Inc volume $150K Russell James PhD Ryals Stephen MD Dalton ENT Associates PC (b) (6) Saintange Judith Jay-Simone AUD St Francis ENT Sampson Dawn F SLP Regional Therapy Services Inc Sams IV Walter Augustus MD Athens Eye Dr & Surgeons Sanderlin Tia Smith MD Sanderson Alice M SLP UGA Sanford Ken E MD 3KB Consultanta Inc Scandrett Tiffany Marie SLP Schacher Stephen MD Athens Occupational Medicine LLC volume $150K Schnapper Robert A MD Atlanta Neurological Associates PC Schoenrock Raymond PhD Schorn-Bellows Marilyn T AUD Gainesville Hearing Services Inc Schuessler Suzanne MD Lagrange Pediatrics Schwartz Sher E PhD Scott Charles MD Wellness & Prevention Inc Sedgwick Charlalee PhD Sellers Ansley Stroud SLP Speech Clinic of The Coastal Empire LLC Sellers Ashely Delois SLP Speech Language & Beyond LLC Sethi Ranjit MD Shaffer Scott PhD Shahid Salles Mohamad MD Sales & Lakhanpal PC Shapiro Molly SLP Pedia Speech Services (b) (6) Sharma Anish MD Barnesville Medical Services Inc Shelby Tracy L PhD Psychological Center for Growth & Development Sherrill Rosalind D SLP Communicative Solutions Group Inc Shih John Y MD Suwanee Family Physicians key primary CE Shin Eric MD Southern Medical Group Shiver Jeremy Dade PhD Sidhpura Jagdish MD Sikod Anna MD Med Plus Disability Evaluations Inc volume $150K Singh Rekha MD Total Medical Care Inc (b) (6) Sinlah Nmamah SLP Kidspeech Inc (b) (6) Siwy James PhD Slaughter Christopher PhD Monarch Behavioral Health Inc Slay Versie Lee MD Med Plus Disability Evaluations Inc volume $150K Small Karen Suzzette SLP Communicative Solutions Group Inc Smalley Glendon William MD Dublin Eye Associates PC Smith Todd PhD South Georgia Neuropsychological Associates PC Smith Ryan MD Eye Physicians & Surgeons of Augusta PC Snook Steven PhD volume $150K Spaniol Joseph Robert MD Med Plus Disability Evaluations Inc volume $150K Sparks Susan Wilkes SLP Speech Hearing & Rehabilitation Sperr Edwin PhD Sperr Shelby PhD Stanley Morgan Dull SLP Looper Speech & Hearing Center (b) (6) Stephens Rebecca PhD Stewart Scott Jay PhD Southeastern Psychological Consultants Stewart James Alfred OPT Georgia Eye Partners Stewart Zachary MD Med Plus Disability Evaluations Inc volume $150K Stillman Mark A PhD MA Stillman PhD & Associates Inc Stokes Desire' Searcy SLP Step N Stones Speech Language Services Storms Robert PhD Streiff Irwin G. MD Med Plus Disability Evaluations Inc volume $150K (b) (6) Stutts William PhD Subrahmanian Kavita Joshi PhD Berger Psychological Services PC Suit James Ivory MD Eye Physicians Professional Association Sumner Anita Marie SLP The Language Learning Center Super Eileen Nikko MD Med Plus Disability Evaluations Inc volume $150K (b) (6) Swain Susan M AUD Hearing Plus Inc Syed Saima MD AIM Medical Szwarc Brian James MD ENT Associates of SW Georgia LLC Taormina Michael MD The Neurological Center of East GA PC Taylor Jennifer Daughtrey SLP Therapy Solution of Georgia Inc Thangavelu Arasi MD South Georgia Medical LLC Thompson Monica L PSY Lyn Psychology & Associates LLC Todd Brook Cox SLP Childrens Therapy Group Inc Trimble Arcella Jean Keys PhD A Healing Paradigm LLC volume $150K Tu (Turk) Althea Lorraine MD Regional Eye Center Tung William MD Turk Chanh MD Regional Eye Center Turknett Joshua MD DeKalb Neurology Group LLC Turner Miriam OPT Midtowne Vision Center Turner M Kevin PhD Transitions of Augusta Turner Joyce Marie SLP Ussery Donna Renee PhD Valentine Christopher St Patrick MD Canduceus Occupational Medicine LLC Vaught Samuel F AUD Auditology Center of Snellville Vega Manuel Arnaldo MD Cardiology Associates of Dublin Vessel-McGee Alethea Faye SLP Better Speech & Language Inc Wachtel Daniel J PhD Pioneer Psychological Associates Wagenhorst Bret Bouton MD Tifton Ophihalmology Walker Paul MD Pointmed Inc key primary CE Walker Larry Dean PhD Walsh Robin PhD The Journey Counseling Washington Andrea MD Watson Byron Maurice MD Med Plus Disability Evaluations Inc volume $150K Weitzman-Swain Ann PhD Eating Disorders Recovery Center of Athens Welch Lisa MD CTA Healthcare LLC West Becky PT West Rehab Services Whitcomb David MD White Milton MD Atlanta Better Health PC Whitley, III John C PhD volume $150K Wiener Alice PhD Wiggs Shaddai N SLP Clear Speech LLC Wiksell Carla Maria SLP Chattanooga Hamilton Co Speech & Hearing Center Wildstein Albert MD Metro Vascular PC Williams Marie PhD Talk Works Inc Williams Joanne MD Alta Medical Consulting Services LLC volume $150K Williams Rhonda MD Internal Medicine Associates of Waycross PC Williamson Stanford Anthony DO Physician Disability Examination Services Inc volume $150K Wilson Erica Renee SLP Clear Speech LLC Winstead Timothy Gene AUD Hearing Doctors of Georgia Wise Larry Andrew AUD St Francis ENT Wong Rosalinda SLP Kidspeech Inc Wood Jimmy PT Horizon Physical Therapy & Rehabilitation Inc Wood Frank MD Wood, Jr Robert Warner MD Wright Carmen H AUD Hearing Associates PC Wu Xiaowen MD Alpoharetta Family Medical Clinic Wyatt Massi PhD (b) (6) Yarborough Alicia Joy SLP Kidspeech Inc Zafrani Shayan Greg MD Alta Medical Consulting Services LLC volume $150K Zdonczyk Daniel MD Zuck Caroline E H AUD Savannah Speech & Hearing Hawaii FY 2017 Vendor list

2017 Specialty 1st CE appt 2017 top 5 Key vendors 2017 Onsite visits Reason for onsite visit (b) (6) 1 Belcher, Daniel, MD IM 12/28/1992 9/22/2017 onsite visit 2 Bratton, Joseph, PhD Psychology 5/24/1997 1 9/22/2017 Volume/Key vendor 3 Cazin, Antoine, MD IM 6/22/2006 5 9/19/2017 Volume/Key vendor 4 Coschignano, Deanna, Phd Psychology 12/3/2011 2 5/25/2017 Volume/Key vendor 5 Donovan, Dennis, Phd Psychology 5/5/2007 3 9/12/2017 Volume/Key vendor 6 Drs. Lui, Lai & Assoc. Optometry 5/13/2009 7 Hashimoto, Don, Psy.D Psychology 8/5/2004 8 I Ola Lahui, Inc. Psychology 5/10/2011 8/14/2017 9 Luke, Stanley, Phd Psychology 7/28/2000 10 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/2015 11 McDermott, Heather, Psyd Psychology 1/2/2014 12 McNamara, Kathleen, Phd Psychology 8/26/1998 13 McNichols, Brandon, Psyd Psychology 5/6/2017 5/6/2017 (b) (6) 14 MSLA IM 11/17/2011 15 Murakami, Wilson, MD IM 4/4/1994 16 Pang, Edith, MD IM 6/18/2016 17 Park, Gregory, MD Psychiatric 11/21/2006 18 Rabara, Michael, Psyd Psychology 1/24/2017 19 Robb Shibayama, OD, IN Optometry 9/19/2012 20 Ruth, Marylee Audiology 4/6/2011 21 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/2002 22 Taketa, Steven, Psyd Psychology 2/14/2015 4 5/6/2017 Volume/Key vendor 23 Triolo, Santo, Phd Psychology 4/6/2015 24 Zafrani, Michael, MD Psychiatric 4/21/2005

Date of First LOSSES: Specialty Exam Reason for leaving Last Exam Fulsand, Elise, MD, JD IM 10/27/2016 1/17/2017 Lind, Dennis, MD Psychiatry 12/19/1995 (b) (6) 12/20/2016 Ohana Psychology Psychology 9/23/2011 4/25/2017

No panelist removed due to inactive license, sanction, or other causes.

Indicates NEW CEPs Vendor list

2016 Specialty Date of First Exam 2016 top 5 Key vendors 2016 Onsite visits 1 Belcher, Daniel, MD IM 12/28/1992 2 Bratton, Joseph, PhD Psychology 5/24/1997 TOP 5 key and volume X 3 Cazin, Antoine, MD IM 6/22/2006 4 Coschignano, Deanna PhD Psychology 12/3/2011 TOP 5 key and volume X 5 Donovan, Dennis, PhD Psychology 5/5/2007 TOP 5 key and volume 6 Drs. Lui, lai & Assoc. (optometrist) Optometry 5/13/2009 7 Hashimoto, Don, Psy.D Psychology 8/5/2004 8 I Ola Lahui (Psychologist) Psychology 5/10/2011 9 Lind, Dennis, MD Psychiatry 12/19/1995 10 Luke, Stanley, Phd Psychology 7/28/2000 11 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/2015 X 12 McDermott, Heather, Psyd Psychology 1/2/2014 13 McNamara, Kathleen, Phd Psychology 8/26/1998 14 MSLA IM 11/17/2011 TOP 5 key and volume 15 Murakami, Wilson, MD IM 4/4/1994 16 Ohana Psychological Svcs LL Psychology 9/24/2011 TOP 5 key and volume X 17 Park, Gregory, MD Psychiatric 11/21/2006 18 Robb Shibayama, OD, IN Optometry 9/19/2012 19 Ruth, Marylee Audiology 4/6/2011 20 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/2002 21 Taketa, Steven, Psyd Psychology 2/14/2015 22 Triolo, Santo, Phd Psychology 4/6/2015 23 Zafrani, Michael, MD Psychiatric 4/21/2005 24 Edith Pang, MD IM 6/18/2016 25 Elise Fulsang, MD IM 10/27/2016

LOSSES: Specialty Date of First Exam Reason for leaving Last Exam Kimberly Kudaishi, MS, CCC SLP 2/2/2008 12/12/2015 Jeremy Lam, MD Pediatric 6/23/2005 (b) (6) 4/14/2016 Na Pu uwai NHHCS Psychology 3/23/2015 8/26/2015 Wingert, John, Phd Psychology 4/25/2005 8/29/2016

No panelist removed due to inactive license, sanction, or other causes.

Indicates NEW Vendor list

2015 Specialty 1st CE appt 2015 top 5 Key vendors 2015 Onsite visits 1 Belcher, Daniel, MD IM 12/28/1992 2 Bratton, Joseph, PhD Psychology 5/24/1997 2 3 Cazin, Antoine, MD IM 6/22/2006 4 Coschignano, Deanna, Phd Psychology 12/3/2011 1 X 5 Donovan, Dennis, Phd Psychology 5/5/2007 3 6 Drs. Lui, Lai & Assoc. Optometry 5/13/2009 7 Hashimoto, Don, Psy.D Psychology 8/5/2004 8 I Ola Lahui, Inc. Psychology 5/10/2011 X 9 Kudaishi, Kimberly, MS, CCC SLP 2/2/2008 10 Lam, Jeremy, MD Pediatric 6/23/2005 11 Lind, Dennis, MD Psychiatry 12/19/1995 12 Luke, Stanley, Phd Psychology 7/28/2000 13 Marchetto-Ryan, Matthew, Psyd Psychology 7/28/2015 14 McDermott, Heather, Psyd Psychology 1/2/2014 15 McNamara, Kathleen, Phd Psychology 8/26/1998 16 MSLA IM 11/17/2011 5 X 17 Murakami, Wilson, MD IM 4/4/1994 18 Na Pu uwai NHHCS Psychology 3/23/2015 19 Ohana Psychological Svcs LL Psychology 9/24/2011 4 X 20 Park, Gregory, MD Psychiatric 11/21/2006 21 Robb Shibayama, OD, IN Optometry 9/19/2012 22 Ruth, Marylee Audiology 4/6/2011 23 Sunamoto, Kenneth, MD Orthopedic/IM 7/15/2002 24 Taketa, Steven, Psyd Psychology 2/14/2015 X 25 Triolo, Santo, Phd Psychology 4/6/2015 26 Wingert, John, Phd Psychology 4/25/2005 27 Zafrani, Michael, MD Psychiatric 4/21/2005

Date of First LOSSES: Specialty Exam Reason for leaving Last Exam Gilstein, Kenneth, Phd Psychology Kamaka, Joseph, MD IM 6/23/2014 3/24/2015

No panelist removed due to inactive license, sanction, or other causes.

Indicates NEW Idaho FY 2017

VENDORNBR VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid Count MARIE PARKMAN PSYD I ADEPT BUSINESS SERVI 8065 WEST MAIN RATHDRUM ID 83858 $21,576.50 126 (b) (6) BONNER GENERAL HOSPI ATTN: CARDIO PULMON 520 NORTH THIRD AVE SANDPOINT ID 83864 $583.80 6 EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4 GERALD GARDNER PHD (b) (6) COEUR D ALENE ID 83814 $96,822.00 569 WEST VALLEY MEDICAL 1717 ARLINGTON CALDWELL ID 83605 $939.70 19 ST JOSEPHS RMC (PFT) 415 6TH STREET LEWISTON ID 83501 $1,362.20 14 VALOR HEALTH ATTN: RADIOLOGY DEPT 1202 EAST LOCUST STR EMMETT ID 83617 $182.80 4 ST LUKES RMC C/P 190 E BANNOCK BOISE ID 83712 $2,393.50 24 BINGHAM MEMORIAL HOS ATTENTION: RADIOLOGY 98 POPLAR STREET BLACKFOOT ID 83221 $8,504.00 157 PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $137.63 4 ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169 PATRICK J PARDEN MD (b) (6) COEUR D ALENE ID 83814 $757.00 5 ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $1,079.30 12 GRITMAN MEDICAL CENT ATTN: RADIOLOGY 700 S MAIN STREET MOSCOW ID 83843 $204.00 4 KRAIG C MCGEE MD 333 N 18TH AVE STE B POCATELLO ID 83201 $863.58 7 DAVID N SIM MD (b) (6) BOISE ID 83704 $6,813.40 38 ST LUKES RMC RADIOLO ATTN: RADIOLOGY 190 E BANNOCK BOISE ID 83712 $895.00 17 TETON CARDIOVASCULAR 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $1,468.50 16 CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117 TETON RADIOLOGY OF I 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $5,046.70 100 ST LUKES MAGIC VALLE 775 POLE LINE RD W S TWIN FALLS ID 83301 $1,556.80 16 PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14 EASTERN ID RMC (RADI 3100 CHANNING WAY IDAHO FALLS ID 83404 $180.00 4 ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $3,597.50 70 KOOTENAI MED CTR (PF 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $2,830.70 30 ST JOSEPHS RMC RADIO 307 ST JOHNS WAY LEWISTON ID 83501 $11,597.70 225 ST ALS MED CTR RADIO 1512 12TH AVE RD NAMPA ID 83651 $116.90 2 GREGORY KENT MD CALD (b) (6) CALDWELL ID 83605 $1,798.00 12 BONNER GENERAL HOSPI 520 NORTH THIRD AVE SANDPOINT ID 83864 $1,835.00 32 GREGORY KENT MD MERI (b) (6) MERIDIAN ID 83642 $2,772.00 20 JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256 CLEARWATER VALLEY HO 301 CEDAR OROFINO ID 83544 $174.00 4 ISU SPEECH, HEARING 650 MEMORIAL DRIVE # POCATELLO ID 83209 $77.29 1 CDA KOOTENAI OUTPATI 700 IRONWOOD STE 175 COEUR D ALENE ID 83814 $677.00 14 SCOTT ALLAN MD 526 H SHOUP AVE W TWIN FALLS ID 83301 $384.00 3 ST LUKES RMC RAD MER 520 S EAGLE RD MERIDIAN ID 83642 $14,193.00 240 ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $34.63 2 PF KOOTENAI OP IMAGI 1300 E MULLAN POST FALLS ID 83854 $577.00 10 REBECCA ALEXANDER PH (b) (6) LEWISTON ID 83501 $42,734.50 244 ST LUKES MERIDIAN RM ATTN: PULMONARY FUNC 520 S EAGLE RD MERIDIAN ID 83642 $2,492.00 24 RICHARD T SONNENBERG (b) (6) BOISE ID 83702 $55,571.50 321 CHERYL TURNER MS (b) (6) NAMPA ID 83651 $1,329.00 9 J CRAIG STEVENS MD P (b) (6) PONDERAY ID 83852 $4,124.00 31 JAMES BATES MD (b) (6) MERIDIAN ID 83642 $50,430.00 463 REBECCA ALEXANDER PH (b) (6) MOSCOW ID 83843 $19,384.00 113 WILLIAM JACKLINE EDD (b) (6) SPOKANE WA 99224 $11,563.00 65 ST LUKES MERIDIAN RM ATTN: LABORATORY 520 S EAGLE RD MERIDIAN ID 83642 $62.29 3 ST LUKES ID ELKS HEA 172 SECOND ST SOUTH NAMPA ID 83651 $70.00 1 JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211 INTERMOUNTAIN MEDICA 2929 EAST MAGIC VIEW MERIDIAN ID 83642 $10,974.00 147 (b) (6) RYAN MCKINNON MD (b) (6) CALDWELL ID 83605 $3,264.00 25 MARK CAPENER MD 2065 E 17TH ST STE B IDAHO FALLS ID 83401 $302.00 2 MICHAEL SANT MD (b) (6) ONTARIO OR 97914 $11,644.00 93 KOOTENAI HEART CENTE 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $199.50 1 JOHN L CHRISTENSEN P (b) (6) POCATELLO ID 83201 $23,522.00 132 MICHAEL SANT MD (BOI 600 N ROBBINS RD STE BOISE ID 83701 $7,179.00 48 MICHAEL SANT MD (MER (b) (6) MERIDIAN ID 83642 $8,931.00 59 ALAN L ZOHNER PHD (b) (6) IDAHO FALLS ID 83401 $35,284.00 194 JOHN B CASPER MD INV THE OSPREY BUILDING 4700 N CLOVERDALE RD BOISE ID 83713 $12,587.40 106 BRAD W LEVITT PSYD (b) (6) PAYETTE ID 83661 $27,139.50 150 ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4 RYAN MCKINNON MD NAM SALTZER MEDICAL GROU 215 E HAWAII AVE NAMPA ID 83686 $4,705.00 33 CHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166 MICHAEL P EMERY PHD SAFARI INN DOWNTOWN 1070 GROVE ST BOISE ID 83702 $27,045.00 154 JASON HALVERSON MD(T (b) (6) TWIN FALLS ID 83301 $164.00 1 DONALD M WHITLEY PHD IDAHO PHYSICIANS CLI 98 POPLAR BLACKFOOT ID 83221 $14,069.00 81 REX E HEAD MD REXBUR (b) (6) REXBURG ID 83440 $23,709.00 177 ST LUKES ID ELKS HEA 520 S EAGLE ROAD #12 MERIDIAN ID 83642 $70.00 1 JASON GAGE PHD (b) (6) BOISE ID 83704 $14,687.00 80 DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333 MICHAEL SANT MD(TF) URGENT CARE OF TWIN 2392 ADDISON AVE EAS TWIN FALLS ID 83301 $17,371.00 138 JACOB W KAMMER MD (b) (6) BOISE ID 83704-8767 $499.00 6 NAYA ANTINK MD (b) (6) BOISE ID 83704 $1,632.00 8 RYAN VAN DE GRAAFF M SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $1,102.50 7 SPENCER CHESHIRE AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 KOOTENAI EAR NOSE TH INTERLAKE MEDICAL BU 700 W IRONWOOD DR ST COEUR D'ALENE ID 83814 $164.00 1 PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $10,713.00 206 ST LUKES MCCALL HOSP 1000 STATE ST MCCALL ID 83638 $194.60 2 LAWRENCE E GREEN MD 16060 IDAHO CENTER B NAMPA ID 83687 $10,879.00 65 MARK YAMA PHD ST JOSEPH'S OUTPATIE 428 6TH AVE LEWISTON ID 83501 $15,257.00 82 INTERPATH LABORATORY 496 SHOUP AVE WEST S TWIN FALLS ID 83301 $26.08 2 CHAD MCCORMICK MD KOOTENAI EAR NOSE TH 700 IRONWOOD STE 278 COEUR D'ALENE ID 83814 $492.00 3 CHAD BOUTERSE DO EYE CARE SPECIALISTS 500 PORT DRIVE CLARKSTON WA 99403 $1,369.82 8 KEVIN HILL MD INV 777 HOSPITAL WAY SMO POCATELLO ID 83201 $329.00 3 NELS M SATHER PHD IDAHO STATE HOSPITAL 700 EAST ALICE BLACKFOOT ID 83221 $24,597.00 132 KOOTENAI AUDIOLOGY L 700 IRONWOOD #278 COEUR D'ALENE ID 83814 $309.16 4 NORTHWEST SPECIALTY 1593 E POLSTON AVE POST FALLS ID 83854 $3,175.00 50 NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55 RYAN HULBERT PHD MER OFFICE OF SCOTT P HO 2273 E GALA STE 100 MERIDIAN ID 83642 $22,164.00 115 JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.00 16 RANDALL H HUTCHINGS (b) (6) NAMPA ID 83686 $11,462.20 97 NATASHA MILLER MD 315 E ELM STE 100 CALDWELL ID 83605 $204.00 1 ST ALS HEALTH PLAZA 4400 E FLAMINGO NAMPA ID 83687 $692.20 13 THEODORE W GARDNER P JUSTAMERE INN 401 GOODING ST N STE TWIN FALLS ID 83301 $20,283.50 116 NATHAN WELCH MD 526 SHOUP AVE W STE TWIN FALLS ID 83301 $972.00 7 RIAN CHATTERTON MS C (b) (6) BOISE ID 83713 $2,244.00 11 RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508 RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274 RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326 RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342 (b) (6) SHALISE ADAMS AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $231.87 3 MICHAEL SPACKMAN MD ACHIEVE PHYSICAL THE 4776 N FIVE MILE ROA BOISE ID 83713 $49,415.40 415 COMMUNITY CARE REXBU 72 EAST MAIN REXBURG ID 83440 $4,579.00 70 JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158 PAUL A GERLACH MD (b) (6) IDAHO FALLS ID 83404 $1,539.60 9 KYLAN PETERSON DO ST LUKES CLINIC PHYS 730 N COLLEGE RD STE TWIN FALLS ID 83301 $1,425.67 12 ARTHUR C JONES MD NA 4424 E FLAMINGO STE NAMPA ID 83687 $1,874.00 13 SHALISE ADAMS AUD NA 4424 E FLAMINGO STE NAMPA ID 83687 $456.45 7 GRANT GILBERT PHD ROCK POINT III BUILD 1330 N WASHINGTON #2 SPOKANE WA 99201 $2,724.76 9 SPENCER CHESHIRE AUD 4424 E FLAMINGO STE NAMPA ID 83687 $386.45 5 JAMES WHITAKER DO IN IDAHO JOINT AND SPIN 9510 WEST FAIRVIEW A BOISE ID 83704 $7,714.00 85 MONTY SMICK OD VISION ART EYECARE C 205 WEST INDIANA AVE SPOKANE WA 99205 $2,591.00 20 REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68 REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51 MICHAEL P GIBSON MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $16,327.00 177 MICHAEL J CARRAHER M HERITAGE HEALTH 925 E POLSTON POST FALLS ID 83854 $2,958.50 24 MATTHEW TRAYNOR MD PREMIER EYE CARE OF 2100 PROVIDENCE WAY IDAHO FALLS ID 83404 $9,440.00 57 CORY D WORKMAN AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 RYAN HULBERT PHD CAL AMBITIONS OF IDAHO 524 E CLEVELAND BLVD CALDWELL ID 83605 $9,779.00 52 STACEY HYDE SLP (b) (6) CAREY ID 83320 $612.00 3 EVAN ALLAN MD (b) (6) TWIN FALLS ID 83301 $534.00 4 SENNETT A PIERCE SR (b) (6) LEWISTON ID 83501 $482.58 4 MARTIN SEIDENFELD PH (b) (6) BOISE ID 83704 $51,515.00 315 KEVIN J CHICOINE MD (b) (6) LEWISTON ID 83501 $16,886.00 149 JACOB W KAMMER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $7,839.00 92 GEORGE MASON GARCIA (b) (6) IDAHO FALLS ID 83404 $2,381.30 13 PAULA M NORDSTROM PH (b) (6) NAMPA ID 83651 $15,970.50 91 JAMES BRUCE PHD (b) (6) BOISE ID 83706 $10,730.50 61 DEBRA DAVIS-JOHNSON PO BOX 21 BOISE ID 83704 $10,921.00 61 REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234 REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177 EVAN ALLAN MD (b) (6) BURLEY ID 83318 $375.00 3 BENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824 BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287 BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9 NELS SATHER PHD TH HEALTH AND WELFARE 803 HARRISON STREET TWIN FALLS ID 83301 $6,215.50 34 RYAN HULBERT PHD NAM AMBITIONS OF IDAHO 1002 W SANETTA STREE NAMPA ID 83651 $13,680.00 75 STERLING D. ANDELIN 2539 CHANNING WAY SU IDAHO FALLS ID 83404 $16,042.00 85 DEBRA K MCKINNON DO LEWISTON FAMILY CHIR 3510 12TH STREET STE LEWISTON ID 83501 $15,719.00 123 DAVID R STARR PHD 1815 SOUTH 10TH AVE CALDWELL ID 83605 $143,933.00 850 CORY D WORKMAN AUD 4424 E FLAMINGO STE NAMPA ID 83687 $77.29 1 KAREN TOROSIAN AUD AUDIOLOGY RESEARCH 700 W IRONWOOD #220 COEUR D ALENE ID 83814 $154.58 2 MICHAEL KOENIG MD IN GARDEN VALLEY FAMILY 856 BANKS LOWMAN RD GARDEN VALLEY ID 83622 $239.00 2 DAVID BECKSTEAD MD I PRESTON MEDICAL CLIN 41 N 100 E PRESTON ID 83263 $4.80 1 AARON AFFLECK MD INV (b) (6) IDAHO FALLS ID 83404 $164.00 1 DUSTIN JONES OD INV SALMON RIVER VISION 1301 MAIN ST STE 10 SALMON ID 83467 $201.00 2 MDSI PHYSICIANS GROU MEDICAL DENTAL STAFF THE LLOYD 1201 BULID PORTLAND OR 97232 $235.45 1 EUNICE GARDNER PHD (b) (6) POCATELLO ID 83201-4374 $2,769.00 14 JOHN B CASPER MD MEDICAL CONSULTING S 3023 EAST COPPER POI MERIDIAN ID 83642 $6,011.00 49 CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102 (b) (6) ST AL'S MEDICAL GRP 3041 E COPPER POINT MERIDIAN ID 83642 $1,188.00 27 BOYD K SOUTHWICK DO (b) (6) IDAHO FALLS ID 83404 $185.00 1 DAVID WATERMAN MD (b) (6) LOGAN UT 84341 $248.00 2 JEFFREY ELDER PHD PINGEL LAW OFFICE 2194 CHANNING WAY IDAHO FALLS ID 83404 $9,552.00 53 CIARA C CHRISTENSEN ADVANCED CHIROPRACTI 725 JENSEN GROVE DRI BLACKFOOT ID 83221 $2,614.00 14 MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53 HOWARD SHOEMAKER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $2,085.00 26 JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6 ADAM REYES AUD SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 DAVID G SANFORD PHD (b) (6) BOISE ID 83709 $264.00 2 Idaho FY 2017 Continued

All CE Providers for FY 2017 VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid Count AARON AFFLECK MD INV (b) (6) IDAHO FALLS ID 83404 $164.00 1 ADAM REYES AUD SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 ALAN L ZOHNER PHD (b) (6) IDAHO FALLS ID 83401 $35,284.00 194 ARTHUR C JONES MD NA (b) (6) NAMPA ID 83687 $1,874.00 13 BENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824 BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287 BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9 BINGHAM MEMORIAL HOS ATTENTION: RADIOLOGY 98 POPLAR STREET BLACKFOOT ID 83221 $8,504.00 157 BONNER GENERAL HOSPI ATTN: CARDIO PULMON 520 NORTH THIRD AVE SANDPOINT ID 83864 $583.80 6 BONNER GENERAL HOSPI 520 NORTH THIRD AVE SANDPOINT ID 83864 $1,835.00 32 BOYD K SOUTHWICK DO (b) (6) IDAHO FALLS ID 83404 $185.00 1 BRAD W LEVITT PSYD (b) (6) PAYETTE ID 83661 $27,139.50 150 CDA KOOTENAI OUTPATI 700 IRONWOOD STE 175 COEUR D ALENE ID 83814 $677.00 14 CHAD BOUTERSE DO EYE CARE SPECIALISTS 500 PORT DRIVE CLARKSTON WA 99403 $1,369.82 8 CHAD MCCORMICK MD KOOTENAI EAR NOSE TH 700 IRONWOOD STE 278 COEUR D'ALENE ID 83814 $492.00 3 CHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166 CHERYL TURNER MS (b) (6) NAMPA ID 83651 $1,329.00 9 CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117 CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102 CIARA C CHRISTENSEN ADVANCED CHIROPRACTI 725 JENSEN GROVE DRI BLACKFOOT ID 83221 $2,614.00 14 CLEARWATER VALLEY HO 301 CEDAR OROFINO ID 83544 $174.00 4 COMMUNITY CARE REXBU 72 EAST MAIN REXBURG ID 83440 $4,579.00 70 CORY D WORKMAN AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 CORY D WORKMAN AUD 4424 E FLAMINGO STE NAMPA ID 83687 $77.29 1 DAVID BECKSTEAD MD I PRESTON MEDICAL CLIN 41 N 100 E PRESTON ID 83263 $4.80 1 DAVID G SANFORD PHD (b) (6) BOISE ID 83709 $264.00 2 DAVID N SIM MD (b) (6) BOISE ID 83704 $6,813.40 38 DAVID R STARR PHD (b) (6) CALDWELL ID 83605 $143,933.00 850 DAVID WATERMAN MD (b) (6) LOGAN UT 84341 $248.00 2 DEBRA DAVIS-JOHNSON PO BOX 21 BOISE ID 83704 $10,921.00 61 DEBRA K MCKINNON DO LEWISTON FAMILY CHIR 3510 12TH STREET STE LEWISTON ID 83501 $15,719.00 123 DONALD M WHITLEY PHD IDAHO PHYSICIANS CLI 98 POPLAR BLACKFOOT ID 83221 $14,069.00 81 DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333 DUSTIN JONES OD INV SALMON RIVER VISION 1301 MAIN ST STE 10 SALMON ID 83467 $201.00 2 EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4 EASTERN ID RMC (RADI 3100 CHANNING WAY IDAHO FALLS ID 83404 $180.00 4 EUNICE GARDNER PHD (b) (6) POCATELLO ID 83201-4374 $2,769.00 14 EVAN ALLAN MD (b) (6) TWIN FALLS ID 83301 $534.00 4 EVAN ALLAN MD (b) (6) BURLEY ID 83318 $375.00 3 GEORGE MASON GARCIA (b) (6) IDAHO FALLS ID 83404 $2,381.30 13 GERALD GARDNER PHD (b) (6) COEUR D ALENE ID 83814 $96,822.00 569 GRANT GILBERT PHD ROCK POINT III BUILD 1330 N WASHINGTON #2 SPOKANE WA 99201 $2,724.76 9 GREGORY KENT MD CALD (b) (6) CALDWELL ID 83605 $1,798.00 12 GREGORY KENT MD MERI (b) (6) MERIDIAN ID 83642 $2,772.00 20 GRITMAN MEDICAL CENT ATTN: RADIOLOGY 700 S MAIN STREET MOSCOW ID 83843 $204.00 4 HOWARD SHOEMAKER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $2,085.00 26 INTERMOUNTAIN MEDICA 2929 EAST MAGIC VIEW MERIDIAN ID 83642 $10,974.00 147 INTERPATH LABORATORY 496 SHOUP AVE WEST S TWIN FALLS ID 83301 $26.08 2 ISU SPEECH, HEARING 650 MEMORIAL DRIVE # POCATELLO ID 83209 $77.29 1 J CRAIG STEVENS MD P (b) (6) PONDERAY ID 83852 $4,124.00 31 JACOB W KAMMER MD (b) (6) BOISE ID 83704-8767 $499.00 6 JACOB W KAMMER MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $7,839.00 92 JAMES BATES MD (b) (6) MERIDIAN ID 83642 $50,430.00 463 JAMES BRUCE PHD (b) (6) BOISE ID 83706 $10,730.50 61 JAMES WHITAKER DO IN IDAHO JOINT AND SPIN 9510 WEST FAIRVIEW A BOISE ID 83704 $7,714.00 85 JASON GAGE PHD (b) (6) BOISE ID 83704 $14,687.00 80 JASON HALVERSON MD(T (b) (6) TWIN FALLS ID 83301 $164.00 1 JEFFREY ELDER PHD PINGEL LAW OFFICE 2194 CHANNING WAY IDAHO FALLS ID 83404 $9,552.00 53 JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158 JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6 JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256 JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211 JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.00 16 JOHN B CASPER MD MEDICAL CONSULTING S 3023 EAST COPPER POI MERIDIAN ID 83642 $6,011.00 49 JOHN B CASPER MD INV THE OSPREY BUILDING 4700 N CLOVERDALE RD BOISE ID 83713 $12,587.40 106 JOHN L CHRISTENSEN P (b) (6) POCATELLO ID 83201 $23,522.00 132 KAREN TOROSIAN AUD AUDIOLOGY RESEARCH 700 W IRONWOOD #220 COEUR D ALENE ID 83814 $154.58 2 KEVIN HILL MD INV 777 HOSPITAL WAY SMO POCATELLO ID 83201 $329.00 3 KEVIN J CHICOINE MD (b) (6) LEWISTON ID 83501 $16,886.00 149 KOOTENAI AUDIOLOGY L 700 IRONWOOD #278 COEUR D'ALENE ID 83814 $309.16 4 KOOTENAI EAR NOSE TH INTERLAKE MEDICAL BU 700 W IRONWOOD DR ST COEUR D'ALENE ID 83814 $164.00 1 KOOTENAI HEART CENTE 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $199.50 1 KOOTENAI MED CTR (PF 2003 KOOTENAI HEALTH COEUR D ALENE ID 83814 $2,830.70 30 KRAIG C MCGEE MD 333 N 18TH AVE STE B POCATELLO ID 83201 $863.58 7 KYLAN PETERSON DO ST LUKES CLINIC PHYS 730 N COLLEGE RD STE TWIN FALLS ID 83301 $1,425.67 12 LAWRENCE E GREEN MD 16060 IDAHO CENTER B NAMPA ID 83687 $10,879.00 65 MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53 MARIE PARKMAN PSYD I ADEPT BUSINESS SERVI 8065 WEST MAIN RATHDRUM ID 83858 $21,576.50 126 MARK CAPENER MD 2065 E 17TH ST STE B IDAHO FALLS ID 83401 $302.00 2 MARK YAMA PHD ST JOSEPH'S OUTPATIE 428 6TH AVE LEWISTON ID 83501 $15,257.00 82 MARTIN SEIDENFELD PH (b) (6) BOISE ID 83704 $51,515.00 315 MATTHEW TRAYNOR MD PREMIER EYE CARE OF 2100 PROVIDENCE WAY IDAHO FALLS ID 83404 $9,440.00 57 MDSI PHYSICIANS GROU MEDICAL DENTAL STAFF THE LLOYD 1201 BULID PORTLAND OR 97232 $235.45 1 MICHAEL J CARRAHER M HERITAGE HEALTH 925 E POLSTON POST FALLS ID 83854 $2,958.50 24 MICHAEL KOENIG MD IN GARDEN VALLEY FAMILY 856 BANKS LOWMAN RD GARDEN VALLEY ID 83622 $239.00 2 MICHAEL P EMERY PHD SAFARI INN DOWNTOWN 1070 GROVE ST BOISE ID 83702 $27,045.00 154 MICHAEL P GIBSON MD ST ALS MEDICAL GRP O 315 E ELM SUITE 100 CALDWELL ID 83605 $16,327.00 177 MICHAEL SANT MD (b) (6) ONTARIO OR 97914 $11,644.00 93 MICHAEL SANT MD (BOI (b) (6) BOISE ID 83701 $7,179.00 48 MICHAEL SANT MD (MER (b) (6) MERIDIAN ID 83642 $8,931.00 59 MICHAEL SANT MD(TF) URGENT CARE OF TWIN 2392 ADDISON AVE EAS TWIN FALLS ID 83301 $17,371.00 138 MICHAEL SPACKMAN MD ACHIEVE PHYSICAL THE 4776 N FIVE MILE ROA BOISE ID 83713 $49,415.40 415 MONTY SMICK OD VISION ART EYECARE C 205 WEST INDIANA AVE SPOKANE WA 99205 $2,591.00 20 NATASHA MILLER MD 315 E ELM STE 100 CALDWELL ID 83605 $204.00 1 NATHAN WELCH MD (b) (6) TWIN FALLS ID 83301 $972.00 7 NAYA ANTINK MD (b) (6) BOISE ID 83704 $1,632.00 8 NELS M SATHER PHD IDAHO STATE HOSPITAL 700 EAST ALICE BLACKFOOT ID 83221 $24,597.00 132 NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55 NELS SATHER PHD TH HEALTH AND WELFARE 803 HARRISON STREET TWIN FALLS ID 83301 $6,215.50 34 NORTHWEST SPECIALTY 1593 E POLSTON AVE POST FALLS ID 83854 $3,175.00 50 PATRICK J PARDEN MD (b) (6) COEUR D ALENE ID 83814 $757.00 5 PAUL A GERLACH MD (b) (6) IDAHO FALLS ID 83404 $1,539.60 9 PAULA M NORDSTROM PH (b) (6) NAMPA ID 83651 $15,970.50 91 PF KOOTENAI OP IMAGI 1300 E MULLAN POST FALLS ID 83854 $577.00 10 PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14 PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $137.63 4 PORTNEUF MEDICAL CTR 777 HOSPITAL WAY POCATELLO ID 83201 $10,713.00 206 RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508 RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274 RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342 RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326 RANDALL H HUTCHINGS (b) (6) NAMPA ID 83686 $11,462.20 97 REBECCA ALEXANDER PH (b) (6) LEWISTON ID 83501 $42,734.50 244 REBECCA ALEXANDER PH (b) (6) MOSCOW ID 83843 $19,384.00 113 REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68 REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234 REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51 REX E HEAD MD REXBUR (b) (6) REXBURG ID 83440 $23,709.00 177 REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177 RIAN CHATTERTON MS C (b) (6) BOISE ID 83713 $2,244.00 11 RICHARD T SONNENBERG (b) (6) BOISE ID 83702 $55,571.50 321 RYAN HULBERT PHD CAL AMBITIONS OF IDAHO 524 E CLEVELAND BLVD CALDWELL ID 83605 $9,779.00 52 RYAN HULBERT PHD MER OFFICE OF SCOTT P HO 2273 E GALA STE 100 MERIDIAN ID 83642 $22,164.00 115 RYAN HULBERT PHD NAM AMBITIONS OF IDAHO 1002 W SANETTA STREE NAMPA ID 83651 $13,680.00 75 RYAN MCKINNON MD (b) (6) CALDWELL ID 83605 $3,264.00 25 RYAN MCKINNON MD NAM SALTZER MEDICAL GROU 215 E HAWAII AVE NAMPA ID 83686 $4,705.00 33 RYAN VAN DE GRAAFF M SOUTHWEST IDAHO ENT 900 N LIBERTY STE 40 BOISE ID 83706 $1,102.50 7 SCOTT ALLAN MD (b) (6) TWIN FALLS ID 83301 $384.00 3 SENNETT A PIERCE SR (b) (6) LEWISTON ID 83501 $482.58 4 SHALISE ADAMS AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $231.87 3 SHALISE ADAMS AUD NA 4424 E FLAMINGO STE NAMPA ID 83687 $456.45 7 SPENCER CHESHIRE AUD SOUTHWEST IDAHO EAR 900 N LIBERTY STE 40 BOISE ID 83706 $77.29 1 SPENCER CHESHIRE AUD 4424 E FLAMINGO STE NAMPA ID 83687 $386.45 5 ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $1,079.30 12 ST ALPHONSUS MEDICAL 351 SW 9TH ST ONTARIO OR 97914 $3,597.50 70 ST ALS HEALTH PLAZA 4400 E FLAMINGO NAMPA ID 83687 $692.20 13 ST ALS MED CTR RADIO 1512 12TH AVE RD NAMPA ID 83651 $116.90 2 ST AL'S MEDICAL GRP 3041 E COPPER POINT MERIDIAN ID 83642 $1,188.00 27 ST JOSEPHS RMC (PFT) 415 6TH STREET LEWISTON ID 83501 $1,362.20 14 ST JOSEPHS RMC RADIO 307 ST JOHNS WAY LEWISTON ID 83501 $11,597.70 225 ST LUKES ID ELKS HEA 172 SECOND ST SOUTH NAMPA ID 83651 $70.00 1 ST LUKES ID ELKS HEA 520 S EAGLE ROAD #12 MERIDIAN ID 83642 $70.00 1 ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169 ST LUKES MAGIC VALLE 775 POLE LINE RD W S TWIN FALLS ID 83301 $1,556.80 16 ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $34.63 2 ST LUKES MCCALL HOSP 1000 STATE ST MCCALL ID 83638 $194.60 2 ST LUKES MERIDIAN RM ATTN: PULMONARY FUNC 520 S EAGLE RD MERIDIAN ID 83642 $2,492.00 24 ST LUKES MERIDIAN RM ATTN: LABORATORY 520 S EAGLE RD MERIDIAN ID 83642 $62.29 3 ST LUKES RMC C/P 190 E BANNOCK BOISE ID 83712 $2,393.50 24 ST LUKES RMC RAD MER 520 S EAGLE RD MERIDIAN ID 83642 $14,193.00 240 ST LUKES RMC RADIOLO ATTN: RADIOLOGY 190 E BANNOCK BOISE ID 83712 $895.00 17 STACEY HYDE SLP (b) (6) CAREY ID 83320 $612.00 3 STERLING D. ANDELIN (b) (6) IDAHO FALLS ID 83404 $16,042.00 85 TETON CARDIOVASCULAR 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $1,468.50 16 TETON RADIOLOGY OF I 2001 S WOODRUFF STE IDAHO FALLS ID 83404 $5,046.70 100 THEODORE W GARDNER P JUSTAMERE INN 401 GOODING ST N STE TWIN FALLS ID 83301 $20,283.50 116 VALOR HEALTH ATTN: RADIOLOGY DEPT 1202 EAST LOCUST STR EMMETT ID 83617 $182.80 4 WEST VALLEY MEDICAL 1717 ARLINGTON CALDWELL ID 83605 $939.70 19 WILLIAM JACKLINE EDD (b) (6) SPOKANE WA 99224 $11,563.00 65 ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4 $1,790,875.71 13528 Volume and Key Providers VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid Count BENJAMIN KARTCHNER M MOUNTAIN VIEW CHIROP 1624 E SELTICE WAY POST FALLS ID 83854 $78,710.00 824 BENJAMIN KARTCHNER M SANDPOINT CHIROPRACT 400 SCHWEITZER PLAZA PONDERAY ID 83852 $25,784.00 287 BENJAMIN KARTCHNER M LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $1,141.00 9 DAVID R STARR PHD (b) (6) CALDWELL ID 83605 $143,933.00 850 GERALD GARDNER PHD (b) (6) COEUR D ALENE ID 83814 $96,822.00 569 JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256 JERRY DOKE PHD TF 834 FALLS AVE STE 20 TWIN FALLS ID 83301 $37,093.00 211 RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508 RALPH D HECKARD MD I IDAHO WORK CARE/WEIG 203 N HOLMES AVE IDAHO FALLS ID 83401 $29,081.00 274 RALPH D HECKARD MD P ALL AMERICAN CHIROPR THE OFFICE OF DR JES POCATELLO ID 83201 $41,616.20 342 RALPH D HECKARD MD T JOSHUA B OLSEN DC BL 497 EASTLAND DR TWIN FALLS ID 83301 $33,431.50 326 REX E HEAD MD MOUNTAIN VIEW CHIROP 1624 EAST SELTICE WA POST FALLS ID 83854 $8,068.00 68 REX E HEAD MD BLACKF ELLIS CHIROPRACTIC 512 W JUDICIAL ST BLACKFOOT ID 83221 $30,557.00 234 REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51 REX E HEAD MD REXBUR (b) (6) REXBURG ID 83440 $23,709.00 177 REX E HEAD MD TF WILLIAMS CHIROPRACTI 1015 WASHINGTON ST N TWIN FALLS ID 83301 $22,949.00 177 $679,789.20 5163 CE Providers Removed None CE Provider Onsight Completed VENDNAME ADDR1 ADDR2 CITY STATE ZIP Total Paid Count CHARLES BOGE MD AMMON MEDICAL & URGE 3456 E 17TH ST STE 1 AMMON ID 83406 $18,456.00 166 CHRISTINE PICKFORD P 1655 FAIRVIEW SUITE MAIN STREET PLAZA BOISE ID 83702 $19,623.00 117 CIARA C CHRISTENSEN JOSHUA B OLSEN DC BL 497 EASTLAND DRIVE TWIN FALLS ID 83301 $16,979.50 102 DAVID R STARR PHD (b) (6) CALDWELL ID 83605 $143,933.00 850 DONALD M WHITLEY PHD PHYSICIAN AND SURGEO 1151 HOSPITAL WAY BL POCATELLO ID 83201 $58,146.00 333 EASTERN ID RMC (PULM 3100 CHANNING WAY IDAHO FALLS ID 83404 $389.20 4 EUNICE GARDNER PHD (b) (6) POCATELLO ID 83201-4374 $2,769.00 14 GERALD GARDNER PHD (b) (6) COEUR D ALENE ID 83814 $96,822.00 569 JEFFREY ELDER PHD CN CENTERPOINT COUNSELI 393 EAST SECOND NORT REXBURG ID 83440 $27,313.00 158 JENNIFER HENDERSON P INNOVATIVE HEALTH CA 115 EAST 16TH STREET IDAHO FALLS ID 83404 $902.00 6 JERRY DOKE PHD 10448 GARVERDALE CT SUITE 612 BOISE ID 83704 $45,269.50 256 JOANN HAMMOND SLP 1820 E 17TH SUITE 27 IDAHO FALLS ID 83404 $2,588.0016 JOHN L CHRISTENSEN P (b) (6) POCATELLO ID 83201 $23,522.00 132 KEVIN J CHICOINE MD (b) (6) LEWISTON ID 83501 $16,886.00 149 MARIE PARKMAN PSYD WESTWOOD PLAZA 13785 HIGHWAY 53 UNI RATHDRUM ID 83858 $8,603.50 53 MICHAEL SANT MD (BOI (b) (6) BOISE ID 83701 $7,179.00 48 NELS SATHER PHD FR TWIN FALLS MENTAL HE 823 HARRISON STREET TWIN FALLS ID 83301 $9,425.00 55 PORTNEUF MEDICAL CEN 777 HOSPITAL WAY POCATELLO ID 83201 $1,362.20 14 RALPH D HECKARD MD B ADVANTAGE WALK-IN CH 2013 E HOSPITALITY L BOISE ID 83716 $54,413.00 508 REBECCA ALEXANDER PH (b) (6) LEWISTON ID 83501 $42,734.50 244 REX E HEAD MD LEW LEWISTON FAMILY CHIR 3510 12TH STREET SUI LEWISTON ID 83501 $7,212.00 51 RYAN MCKINNON MD (b) (6) CALDWELL ID 83605 $3,264.00 25 ST LUKES MAGIC VALLE 775 POLE LINE RD W TWIN FALLS ID 83301 $8,552.00 169 STERLING D. ANDELIN (b) (6) IDAHO FALLS ID 83404 $16,042.00 85 ZACK HALE MS 3345 MERLIN DR STE 2 IDAHO FALLS ID 83404 $309.16 4 $632,694.56 4128 PROVIDERS-OVERSIGHT FFY 2017 ILLINOIS ABC PEDIATRIC AHMED, AZIZ MD AKTAR, RIAZ MD Onsite review comleted AMDUR, MARK MD ANUKWU, LINUS MD ANYANWU, JOVITA MD Key/High Volume provider Onsite review completed- ARTHRITIS & INT MED SPEC Multiple sites meets threshhold Chicago, Elgin, Skokie AUDIOLOGY CONSULT Multiple sites BELTRAN, NORA MD BILAS, KRISTIN SLP BONSKY, LAURA PSYD BOYD, JERRY PHD Multiple sites BRAUER, JOHN PSYD Multiple sites BUCH, PIYUSH MD BYERS-SPRAETZ, JEANNE SLP CGH MEDICAL CENTER Key/High Volume provider Onsite review completed-East CHAPA, VITTAL MD Multiple sites meets threshhold Peoria CHEAK, ERIN SLP Key/High Volume provider CHICAGO CONSULTING PHYS meets threshhold Onsite review completed CHICAGO GLAUCOMA CONSULT CHILD & FAMILY PSYCH CTR CHO, SUNG JIN PSYD CILINO-FOLKS (formerly Aurand) JENNIFER PSYD COLLINSWORTH, LINDA PHD COX, BEVERLY PHD CUNNINGHAM, JEAN PHD DAILEY, JOHN MD DAVENPORT, TERESA PHD Multiple sites DAY, JOHN & ASSOC Key/High Volume provider Onsite review completed- DEPPE, HARRY PHD Multiple sites meets threshhold Centralia DOYLE, SHANNON PHD DYSON, VIDA PHD EAST WEST INT MED Multiple sites ELMUDESI, FRANK J PSYD Key/High Volume provider Onsite review completed- FEINERMAN, ADRIAN MD Multiple sites meets threshhold Centralia FROMAN, FRANK EDD GARCIA, PHILIP MD Multiple sites GARG, RAKESH MD GO, DENNIS MD GOEBEL, J B PHD GOOD SAMARITAN REG HLTH CTR Key/High Volume provider Onsite review completed-Hazel GOZI MEDICAL & OCC HLTH Multiple sites meets threshhold Crest GREEN, OLGA PSYD GROESCH, DAVID SLP Multiple sites GUPTA, SANDEEP MD HARDY, STEPHEN PHD HARRIS, BRENDA SLP HASSON, ALBERT MD HAUSER-ROSS EYE INST HEINRICHS, KENNETH PSYD HERNANDEZ, NIKKI PHD HILGER, SANDRA SLP Multiple sites HOOVER & ASSOC HOUSE, ALVIN PHD JACOBS, ALAN PHD JAIN, DINESH MD JAIN, MUKESH MD JESWANI, SEEMA MD JFJ EYECARE JOHNSTON, CHRISTY SLP Multiple sites JOYNER THERAPY Multiple sites KAHLON, SURINDERPAL MD KANAGARAJU, BALA MD Key/High Volume provider KARR, JEFFREY PHD meets threshhold Onsite review completed KETTERING, RANDY PHD KIMBEL, PATRICIA PSYD KING, JASON PSYD KLUG, FRED, PHD Multiple sites KNOPF, NORTON PHD KOGAN, ALAN MD KOGAN, JULIA MD KOHEN, WILLIAM PSYD KRUCEK, MICHELLE PSYD LAGOUROS, EVAN MD Key/High Volume provider LAKE SHORE MEDICAL CLINIC meets threshhold Onsite review completed LAKESIDE EYE GROUP Key/High Volume provider Onsite review completed- LANGGUT, MARK PHD Multiple sites meets threshhold Ottawa LATHAM, ALISON SLP LEE, KAREN PSYD LEVITAN, KENNETH MD LOUCK DAVIS, AMY PSYD LUCIETTO-SIERADZKI, THERESE MD LUDWIG, GARY PHD L & Y GROUP MARKS-FREY, MARILYN PHD MCELHENNEY, RISE SLP Key/High Volume provider MEDICAL EVALUATION CTR meets threshhold Onsite review completed MIDDLETON, KIMBERLY MD MIDTOWN PHYSICIANS Multiple sites Key/High Volume provider MUNOZ, GILBERTO MD Multiple sites meets threshhold Onsite review completed MUZAFFAR, ZAHIDA MD NADKARNI, U P MD NAGPAL-ARORA ASSOC NORTHWEST EYE OGBEVOEN, JUSTIN MD OKOLI, UZOMA MD OLAUGHLIN, CHARLES MD OMONDI, PRICE DO OSAFO HEALTHCARE OSF REHAB SVCS OSTROWSKI, MICHAEL EDD PATIL, M S MD PETERSON, JAMES PHD Multiple sites Key/High Volume provider Onsite review completed-Lake PHYS MGT NORTH, SYSTEM, WEST Multiple sites meets threshhold Zurich, Chicago, Hillside PIMENTEL, DANTE MD POWELL, DAVID AUD PRAIRIE EYE PRAIRIE WIND Multiple sites PROFESSIONAL EYE PROGRESSIVE EYE PSYCHCARE ASSOC Key/High Volume provider Onsite review completed- PSYCHOLOGY CONSULT Multiple sites meets threshhold Rockford QUANTUM VISION Multiple sites QUINN, MIRJAM PHD RAFIQ, MUHAMMAD MD Multiple sites RAHMAN, AZIZ MD Key/High Volume provider RAMCHANDANI, K P MD meets threshhold Onsite review completed RUSSELL, JOHN OD SCHIER, LESLIE MD Multiple sites SCHULTZ, LYNETTE PSYD SEBASTIAN, FELICITAS PHD SHAH, PRANJAL MD SHAH, SYED MD SHEVLYAGIN, SERGEI MD SHUKHMAN, MARK MD SICHER, STEVEN MD Key/High Volume provider Onsite review completed- SIGNATURE CONSULT Multiple sites meets threshhold Sycamore SINGH, PARAMJEET MD SO IL INST BEHAVIOR HLTH SPEECH & LANG REHAB STAHNKE, ROBERTA PSYD STELLING, FRED MA STERZIK, TIMOTHY PSYD Onsite review completed STILES, WILLIAM MD ST MARYS ADULT & GERIATRIC SWANSON, ERICKA PSYD Key/High Volume provider Onsite review completed- TAIWO, AFIZ MD Multiple sites meets threshhold Princeton, Peoria TAMRAGOURI, RAVIKIRAN MD THERAPY CARE THOMAS-STAGG, JONATHAN PHD Multiple sites TRELLO, DOLORES PSYD Multiple sites TRIEGER, MICHAEL PSYD VETTER, MARIE AUD Multiple sites Key/High Volume provider VINCENT, STEPHEN PHD Multiple sites meets threshhold Onsite review completed-Alton VOSS, VALERIE MD Multiple sites VYAS, KETAN MD WANG, PAUL MD WARSHAUER, DAVID PHD WASHINGTON COUNTY HOSP & RURAL HLTH CLINIC WEGIEREK, ANNA PSYD Key/High Volume provider WEST PARK MEDICAL Multiple sites meets threshhold Onsite review completed-Alton WISE, JOAN PSYD WITHERSPOON, KIRK PHD WRIGHT, SARAH PSYD WURGLITZ, GLEN PSYD YALAMANCHILI, SARAT MD YORK-ANDERSON, DOLLEAN PHD

IOWA ANDERREGG, THOMAS PHD

MISSOURI FOREST PARK MEDICAL

**There were no CE Panelists removed because of inactive license, sanction, or due cause. INDIANA DDS FY 2017 CE PROVIDER LIST VendCd Off Type Name PS nbr PRO Tmp? Inact sDt C IU HEALTH BEDFORD HOSPITAL N 0 (b) (6) C IU HEALTH BEDFORD HOSPITAL (b) (6) N 0 C IU HEALTH BEDFORD HOSPITAL N 0 C IU HEALTH ARNETT CARDIOLOGY (ECHO) N 0 C IU HEALTH ARNETT CARDIOLOGY (TET) N 0 C INDIANA UNIVERSITY HEALTH ARNETT (XRAY) N 0 C INDIANA UNIVERSITY HEALTH ARNETT (PULM) N 0 C THE SOUTH BEND CLINIC (ENT) N 0 C SOUTH BEND CLINIC (PFS) N 0 C SOUTH BEND CLINIC(LABS X RAYS) N 0 C SOUTH BEND CLINIC (OPT) N 0 C IU HEALTH BALL MEMORIAL HOSPITAL N 0 C IU HEALTH BALL MEMORIAL HOSPITAL N 0 C IU HEALTH BALL MEMORIAL HOSPITAL N 0 C IU HEALTH BALL MEMORIAL HOSPITAL N 0 C MARION GENERAL HOSPITAL N 0 C MARION GENERAL HOSPITAL (PFS ONLY) N 0 C MARION GENERAL HOSPITAL N 0 C ST CATHERINE HOSPITAL (LABS/XR) N 0 C ST CATHERINE HOSPITAL (PULM) N 0 C ST CATHERINE HOSPITAL (SLP) N 0 C ST. JOSEPH HOSPITAL N 0 C ST. JOSEPH HOSPITAL N 0 C ST. JOSEPH HOSPITAL(LABS & XRAYS) N 0 C ST. JOSEPH HOSPITAL N 0 C ST. JOSEPH HOSPITAL N 0 C MD IMAGING N 0 C MD IMAGING (X-RAYS) N 0 C ST. JOSEPH HOSPITAL(PFS/EKGS/PULSE OX) N 0 C ST. JOSEPH HOSPITAL (ECHOS) N 0 C ST. JOSEPH HOSPITAL( DOPP) N 0 C ST JOSEPH REGIONAL MEDICAL CENTER N 0 C ST. JOSEPH REGIONAL MEDICAL CENTER N 0 C ST. JOSEPH REGIONAL MEDICAL CENTER N 0 C ST JOSEPH REGIONAL MEDICAL CENTER N 0 C IU HEALTH METHODIST HOSPITAL (PUL) N 0 C IU HEALTH METHODIST HOSPITAL (LAB) N 0 C UNION HOSPITAL WEST N 0 C UNION HOSPITAL AT CLINTON N 0 C UNION HOSPITAL WEST(SLP) N 0 C UNION HOSPITAL (X-RAYS) N 0 C UNION HOSPITAL CLINTON (XR) N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ST VINCENT ANDERSON REGIONAL HOSPITAL, INC. N 0 C ENT ASSOCIATES OF SOUTHERN IN N 0 C REID MEMORIAL HOSPITAL N 0 C REID MEMORIAL HOSPITAL (LABS & XRAY) N 0 C REID HOSPITAL AND HEALTH CARE SERVICES N 0 C KINGS DAUGHTERS HEALTH N 0 C KINGS DAUGHTERS HEALTH N 0 C KINGS DAUGHTERS HEALTH N 0 C KINGS DAUGHTERS HEALTH N 0 C KINGS DAUGHTERS HEALTH N 0 C ST FRANCIS HOSPITAL CENTER N 0 C ST ELIZABETH EAST N 0 C ST ELIZABETH CENTRAL N 0 C ST ELIZABETH EAST N 0 C ST ELIZABETH EAST (CARDIO) N 0 C ST ELIZABETH EAST (LABS) N 0 (b) (6) C IU HEALTH BLOOMINGTON HOSPITAL (RESP) (b) (6) N 0 C IU HEALTH BLOOMINGTON HOSPITAL (VASC) N 0 C IU HEALTH BLOOMINGTON HOSPITAL N 0 C SCOTT MEMORIAL HOSPITAL N 0 C SCOTT MEMORIAL HOSPITAL N 0 C SCOTT MEMORIAL HOSPITAL N 0 C SCOTT MEMORIAL HOSPITAL (PFS/DLCO) N 0 C COMMUNITY HOWARD REGIONAL HEALTH INC. N 0 C COMMUNITY HOWARD REGIONAL HEALTH INC. N 0 C COLUMBUS REGIONAL HOSP (LABS X RAYS) N 0 C COLUMBUS REGIONAL HOSP (ECHOS) N 0 C COLUMBUS REGIONAL HOSP (PFTS,ABG) N 0 C PUTNAM COUNTY HOSPITAL N 0 C PUTNAM COUNTY HOSPITAL(LABS) N 0 C PUTNAM COUNTY HOSPITAL(X RAYS) N 0 C IU HEALTH STARKE HOSPITAL N 0 C IU HEALTH STARKE HOSPITAL N 0 C IU HEALTH STARKE HOSPITAL N 0 C IU HEALTH STARKE HOSPITAL N 0 C IU HEALTH STARKE HOSPITAL N 0 C STARKE HOSPITAL N 0 C STARKE HOSPITAL N 0 C STARKE HOSPITAL N 0 C STARKE HOSPITAL N 0 C STARKE HOSPITAL N 0 C EVANSVILLE SURGICAL ASSOCIATES N 0 C AP HOLD N0 C MSD HOLD N0 C PRD HOLD N0 C ODAR HOLD N0 C MIDWEST EAR INSTITUTE N 0 C THE CONSULTING CENTER (KEPES) N 0 C THE CONSULTING CENTER - LESLIE PREDINA N 0 C WAYNE VON BARGEN, PH.D. N 0 C TERRE HAUTE REGIONAL HOSPITAL N 0 C TERRE HAUTE REGIONAL HOSPITAL( ABG/PULSE OX) N 0 C TERRE HAUTE REGIONAL HOSPITAL N 0 C TERRE HAUTE REGIONAL HOSPITAL N 0 C TERRE HAUTE REGIONAL HOSPITAL N 0 C TERRE HAUTE REGIONAL HOSPITAL( PFT/DLCO) N 0 C M HILLIARD ROSEFF MD N 0 C DION J. DULAY, M.D. N 0 C TERRE HAUTE HEART CENTER N 0 C MAX A HENRY MD (C) N 0 C MAX A HENRY MD (G) N 0 C MICHELE KOSELKE, PSY.D. (LEBANON) N 0 C MICHELE KOSELKE, PSY.D. (LAF) N 0 C RALPH INABNIT, D.O. (SB) N 0 C RALPH INABNIT, D.O. (SB PFS) N 0 C DONALD M. PEREZ, M.D. N 0 C JULIE PELLETIER,PHD N 0 C GOOD SAMARITAN HOSPITAL N 0 C GOOD SAMARITAN HOSPITAL N 0 C GOOD SAMARITAN HOSPITAL N 0 C GOOD SAMARITAN HOSPITAL N 0 C RILEY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C DEARBORN COUNTY HOSPITAL N 0 C BAPTIST HEALTH (FLOYD) PFS/DLCO N 0 C BAPTIST HEALTH (FLOYD) TET N 0 (b) (6) C BAPTIST HEALTH (FLOYD) LAB (b) (6) N 0 C BAPTIST HEALTH (FLOYD) ABG N 0 C BAPTIST HEALTH (FLOYD) SLP N 0 C BAPTIST HEALTH (FLOYD) DOPPLERS N 0 C BAPTIST HEALTH (FLOYD) TET-JEFF N 0 C UNIVERSITY OF CHICAGO HOSPITAL N 0 C DOCTORS EYE INSTITUTE N 0 C DOCTORS EYE INSTITUTE (OPT) N 0 C GLENN STEWART DAVIDSON, JR., PH.D. N 0 C JEFFREY W. GRAY, PH.D. (E) N 0 C THOMAS A SMITH PHD N 0 C HOWARD WOODEN, PH.D. (T) N 0 C HOWARD WOODEN, PH.D. (I) N 0 C PATRICK UTZ, PH.D. (SB) N 0 C JOHN NIETERS MD N 0 C SUZANNE LEIPHART PHD N 0 C CHICAGO CONSULTING PHYSICIANS N 0 C CHICAGO CONSULTING PHYSICIANS N 0 C PAUL J ROBERTS PHD HSPP N 0 C JEFFREY T. KARR, PH.D N 0 C CATARACT & LASER INSTITUTE N 0 C SOUTHLAKE SPEECH & HEARING CENTER, INC. N 0 C HEARING & SPEECH ASSOCIATES N 0 C IRENA M WALTERS PSYD N 0 C DAVID W. ZAUEL, M.D. N 0 C DAVID W. ZAUEL, M.D. N 0 C LOGANSPORT MEMORIAL HOSPITAL N 0 C LOGANSPORT MEMORIAL HOSPITAL(PFS/DLCO) N 0 C PERU MEDICAL CENTER N 0 C PERU MEDICAL CENTER (ANC) N 0 C JOYCE SCULLY, PSY.D (GARY) N 0 C RUSH MEMORIAL HOSPITAL (DOPPLER) N 0 C RUSH MEMORIAL HOSPITAL (LABS ONLY) N 0 C RUSH MEMORIAL HOSPITAL (PFS/DLCO) N 0 C RUSH MEMORIAL HOSPITAL (ECHO) N 0 C RUSH MEMORIAL HOSPITAL- TET N 0 C RUSH MEMORIAL HOSPITAL- STRESS ECHO N 0 C J. MARK DOBBS, PSY.D. N 0 C PHILLIP L VANDIVIER ED D N 0 C HUGH VAN AUKEN, SR., PH.D. N 0 C ANCHOR BEHAVIORAL (NC) N 0 C ANCHOR BEHAVIORAL (F) N 0 C ANCHOR BEHAVIORAL (ANDERSON) N 0 C MIDWEST CLINIC N 0 C HAMILTON CENTER- DR. SCHNEIDER (PL) N 0 C HAMILTON CENTER - DR LEAH POWELL (BRAZIL) N 0 C HAMILTON CENTER - ADULT (TH) N 0 C ERIC LEVINE, MD (GREENWOOD) N 0 C IU HEALTH GOSHEN HOSPITAL N 0 C IU HEALTH GOSHEN HOSPITAL (AJ) N 0 C IU HEALTH GOSHEN HOSPITAL (CC) N 0 C IU HEALTH GOSHEN HOSPITAL (AB) N 0 C ROBERT J. KURZHALS, PH.D. (L) N 0 C ROBERT J. KURZHALS, PH.D. (S) N 0 C ALAN H. WAX, PH.D. (M) N 0 C ALAN H. WAX, PH.D. (P) N 0 C ALAN H. WAX, PH.D. (E) N 0 C D MARK BICKERS MD N 0 C DOUGLAS STREICH PH.D. N 0 C FLOYD ROBISON PH.D. N 0 C FLOYD ROBISON PH.D. (BLOOMINGTON) N 0 C ROBERT BLAKE, PH.D. N 0 C INDIANAPOLIS MEDICAL EVALUATION N 0 (b) (6) C UNITED HEALTH SERVICES N 0 C MEDSTAT URGENT CARE (PFS) (b) (6) N 0 C MEDSTAT URGENT CARE (XRAY AND LABS) N 0 C MEDSTAT URGENT CARE WARSAW N 0 C MEDSTAT URGENT CARE (SYRACUSE-ANC) N 0 C MEDSTAT URGENT CARE (SYRACUSE) N 0 C MEDSTAT URGENT CARE NAPPANEE N 0 C MEDSTAT URGENT CARE (XRAY & LABS) NAPPANEE N 0 C MEDSTAT URGENT CARE (PFS-NAPPANEE) N 0 C RUDY YUNG MD N 0 C MID-AMERICA PSYCH COUNSELING SERVICES(M) N 0 C MID-AMERICA PSYCH COUNSELING SERV (G-SINGH) N 0 C MID-AMERICA PSYCH COUNSELING SERV (G-GOPAL) N 0 C MID-AMERICA PSYCH COUNSELING SERV (O'DANOVICH) N 0 C MID-AMERICA PSYCH COUNSELING SERVICES(MUNSTER) N 0 C MICHAEL R WILD MD (K) N 0 C GARY M. DURAK, PH.D. (V) N 0 C LARRY F. FREUDENBERGER, PSY.D. N 0 C CEOLA BERRY PHD (NC) N 0 C CEOLA BERRY PHD (MA) N 0 C BETTYE L. PATE, PSY.D. N 0 C CHRISTOPHER H. SCRUTON, PH.D. N 0 C CRAIG NORDSTROM, PSY.D. (P) N 0 C CRAIG NORDSTROM, PSY.D. (E) N 0 C METHODIST PHYSICIAN GROUP CARDIOVASCULAR CLINIC N0 C VICTOR P. RINI, PSY.D. (VALPO) N 0 C VICTOR P. RINI, PSY.D. (HIGHLAND) N 0 C MICHAEL OBRIEN PSYD (I) N 0 C MICHAEL OBRIEN PSYD (K) N 0 C DAVID A. CAMPBELL, M.D. N 0 C LUZIO & ASSOCIATES-DR. JONES N 0 C ST VINCENT DUNN HOSPITAL N 0 C A & J REHABILITATION SERVICES N 0 C KOSCIUSKO COMMUNITY HOSPITAL(ECHOS) N 0 C KOSCIUSKO COMMUNITY HOSPITAL(PFS/DLCO) N 0 C KOSCIUSKO COMMUNITY HOSPITAL(ABG) N 0 C RUSS RASMUSSEN, PSY.D. N 0 C CANDACE MARTIN PSYD N 0 C GREENWOOD PEDIATRICS & INTERNAL MEDICINE N 0 C PAULA GARDNER PSYD N 0 C COMPREHENSIVE PSYCH SERV (CH) N 0 C COMPREHENSIVE PSYCH SERV (G) N 0 C C KENNETH FISCHER MD N 0 C ACACIA CENTER FOR HUMAN GROWTH & DEVELOPMENT N 0 C JOHNSON MEMORIAL HOSPITAL (LAB) N 0 C JOHNSON MEMORIAL HOSPITAL (X RAYS) N 0 C JOHNSON MEMORIAL HOSPITAL (PULM) N 0 C JOHNSON MEMORIAL HOSPITAL (ECHO) N 0 C ALLISON RUGANI, MA, CCC-SLP N 0 C JILL A MILLER PSYD N 0 C MUNSTER EYE CARE ASSOCIATES, P.C. N 0 C ROSALIND SCHMUTTE PSYD N 0 C IU HEALTH ENT DEPARTMENT (WANGSTROM & BANCROFT) N 0 C IU HEALTH ENT DEPARTMENT (WANGSTROM & BANCROFT) N 0 C BLUFFTON REGIONAL MEDICAL CENTER N 0 C GRETCHEN HADAR CCC,SLP (I) N 0 C JACQUELINE BROOKS, M.ED., CCC-SLP N 0 C KARL W. EVANS, PSYD, HSPP N 0 C KATHRYN NAGDEMAN, MA-CCC N 0 C PAUL DEARDORFF PHD N 0 C NICOLE LEISGANG PSYD (INDY) N 0 C PAUL DEARDORFF PH.D. (INDY) N 0 C NICOLE LEISGANG PSYD (RICHMD) N 0 C PAUL DEARDORFF PH.D. (RICHMD) N 0 (b) (6) C REGINA MCKINNEY PSYD (RICHMD) (b) (6) N 0 C REGINA MCKINNEY PSYD(INDY) N 0 C LONDON PSYCHOLOGICAL SERVICES N 0 C GARY MARYMAN PSYD N 0 C GARY MARYMAN PSYD(BL) N 0 C GARY MARYMAN PSYD(MADISON) N 0 C MAJOR HOSPITAL (LAB) N 0 C MAJOR HOSPITAL (X RAY) N 0 C MAJOR HOSPITAL (PFS) N 0 C MAJOR HOSPITAL N 0 C MAJOR HOSPITAL N 0 C ARSHAD MALIK, M.D. N 0 C ARSHAD MALIK, M.D. (TET) N 0 C SACKS CLINICAL CONSULTING,PC N 0 C JEFFREY SAMELSON, PH.D. (SACKS) N 0 C SHARON SACKS, PHD( SOUTH BEND) N 0 C JOHN T HEROLDT EDD (LA) N 0 C JOHN T HEROLDT EDD (MC) N 0 C JOHN T HEROLDT EDD (M) N 0 C JOHN T HEROLDT EDD (LO) N 0 C SOUTHERN INDIANA EYE ASSC LLC N 0 C CENTRAL IN INTERPRETING SERVICE N 0 C ADVOCATE ILLINOIS MASONIC MEDICAL CENTER N 0 C FLORENCE REZNIK CCC-SLP (CARMEL) N 0 C FLORENCE REZNIK CCC-SLP (ANDERSON) N 0 C CARYN BROWN PSYD (M) N 0 C CARYN BROWN PSYD (L) N 0 C HEUSER HEARING INSTITUTE N 0 C COURTER COMMUNICATIONS, LLC (C) N 0 C COURTER COMMUNICATIONS, LLC N 0 C COURTER COMMUNICATIONS, LLC (K) N 0 C RUSSELL G COULTER-KERN PHD (NMAN) N 0 C RUSSELL G COULTER-KERN PHD (M) N 0 C SOUTHERN INDIANA REHAB HOSPITAL N 0 C PSYCHOLOGICAL & SOCIAL SERVICES N 0 C TODD A SNYDER PSYD (ELKHART) N 0 C JAMES ASCOUGH, PHD, HSPP N 0 C DEBORAH A. ZERA, PSY.D. N 0 C SIMPLY SPEAKING N 0 C MONROE HOSPITAL N 0 C MONROE HOSPITAL N 0 C MONROE HOSPITAL N 0 C MONROE HOSPITAL N 0 C SPEECH AND LANGUAGE PRIORITIES LLC N 0 C SPEECH AND LANGUAGE PRIORITIES (C) N 0 C JULIE WEAVER CCC-SLP N 0 C CONNECTIONS INC N 0 C CONNECTIONS INC (TESTING ONLY) N 0 C ADVANCED OPHTHALMOLOGY ASSOCIATES N 0 C KIMBERLY MORAN PSYD N 0 C GROSSNICKLE EYE CTR (M) N 0 C GROSSNICKLE EYE CTR (E) N 0 C GROSSNICKLE EYE CTR (M)(OPT) N 0 C GROSSNICKLE EYE CTR (E)(OPT) N 0 C BLACKBIRD CLINICAL SERVICES(PFTS-ANC) N 0 C IU HEALTH NEUROPHYSIOLOGY N 0 C RILEY HOSPITAL FOR CHILDREN(HINT) N 0 C CTR FOR PSYCH DEV - DALE N 0 C TRINA VIAN, CCC-SLP N 0 C AAA SPEECH THERAPY SERVICES, LLC. N 0 C WORKING WELL (MC) N 0 C WORKING WELL (MC) LABS/XRAYS N 0 C STEVEN B ASHTON DO N 0 C STEFANIE WADE PSYD N 0 (b) (6) C NWI PATIENT CARE (G) N 0 C NWI PATIENT CARE (GARY-A) (b) (6) N 0 C NWI PATIENT CARE (ECHOS) N 0 C NWI PATIENT CARE (M) N 0 C NWI PATIENT CARE (ECHOS-M) N 0 C NWI PATIENT CARE (ANCILLARIES-M) N 0 C NWI PATIENT CARE (DOPPLER-G) N 0 C NWI PATIENT CARE (DOPPLER-M) N 0 C NWI PATIENT CARE (ELK) N 0 C NWI PATIENT CARE (ELK-ANC) N 0 C NWI PATIENT CARE (ECHOS-ELK) N 0 C LUTHERAN MEDICAL GROUP N 0 C BRIDGET ROBERTS-PITTMAN, PH.D. N 0 C DAWN CASTNER-RECTOR, PH.D. N 0 C INDY BEHAVIORAL HEALTH LLC (I) N 0 C INDY BEHAVIORAL HEALTH LLC (A) N 0 C INDY BEHAVIORAL HEALTH LLC (R) N 0 C DAN BOEN PHD N 0 C ERICKA STEIN, CCC-SLP N 0 C GERALD GRUEN PHD N 0 C TULIP TREE FAMILY HEALTH CENTER N 0 C KALEIDOSCOPE LLC N 0 C JEFFERY HUTTINGER PSYD. N 0 C THE CONSULTING CENTER- DR KAY ROY N 0 C MICHAEL SCHERBINSKI PHD N 0 C ABRAMS EYE CARE ASSOCIATES (C) N 0 C ABRAMS EYE CARE ASSOCIATES (DT) N 0 C ABRAMS EYE CARE ASSOCIATES (I-WEST) N 0 C MATTHEW GRANT, PSYD N 0 C COMMUNITY HOSPITAL OF BREMEN N 0 C NORTHEAST INTERNAL MEDICINE (LAGRANGE) N 0 C NORTHEAST INTERNAL MEDICINE(KENDALLVILLE) N 0 C NORTHEAST INTERNAL MEDICINE (TET-L) N 0 C NORTHEAST INTERNAL MEDICINE (TET-K) N 0 C NORTHEAST INTERNAL MEDICINE (PFT LAGRANGE) N 0 C NORTHEAST INTERNAL MEDICINE (XRAYS L) N 0 C NORTHEAST INTERNAL MEDICINE (L-DOPP) N 0 C NORTHEAST INTERNAL MEDICINE(K-DOPP) N 0 C AMANDA MAYLE PHD N 0 C DAVIESS COMMUNITY HOSPITAL N 0 C E. ANN MILLER PH. D. HSPP N 0 C IRA YOUNGER MD (BATESVILLE) N 0 C IRA YOUNGER MD (LAWRENCEBURG) N 0 C PRIMARY CARE CENTER N 0 C PRIMARY CARE CENTER (LABS ONLY) N 0 C PRIMARY CARE CENTER(ECHOS/PFS/DLCO) N 0 C HEALTHPLEX (LABS/XRAYS ONLY) N 0 C KRISTIN MCGOVERN PHD N 0 C AMBER WHITED, PH.D. N 0 C YUICHUNG CHAN, PHD N 0 C DEBORAH J. MILLER, PHD N 0 C SHRIDHAR VENTRAPRAGADA MD N 0 C DR GEISSLERS HEARING CENTER N 0 C MEMORIAL HOSPITAL(LABS & PFS) N 0 C MEMORIAL HOSPITAL - AUDIOLOGY DEPT N 0 C MEMORIAL HOSPITAL (CARDIAC) N 0 C MERIDIAN DIAGNOSTIC (PFS/DLCO) N 0 C MERIDIAN DIAGNOSTIC (ECHOS) N 0 C MERIDIAN DIAGNOSTIC (DOPPLERS) N 0 C MERIDIAN DIAGNOSTIC (IME-1) N 0 C MERIDIAN DIAGNOSTIC (X RAYS) N 0 C MERIDIAN DIAGNOSTIC (INDY-LABS & LIMITED) N 0 C MERIDIAN DIAGNOSTIC (NEW ALBANY) N 0 C MERIDIAN DIAGNOSTIC (PFS-NEW ALBANY) N 0 C MERIDIAN DIAGNOSTIC (X RAYS NA) N 0 (b) (6) C IMAGING CENTER (XRAYS) (b) (6) N 0 C WORKMED OCCUPATIONAL HEALTH N 0 C WORKMED OCCUPATIONAL HEALTH (PFS) N 0 C RIVERVIEW HOSPITAL (ECHOS) N 0 C HANCOCK REGIONAL HOSPITAL N 0 C HANCOCK REGIONAL HOSPITAL N 0 C PARKWAY MEDICAL CENTER N 0 C BEDFORD OUTPATIENT THERAPY N 0 C JEFFREY NICHOLS MD N 0 C DDJ MEDICAL INC N 0 C DDJ MEDICAL INC (LABS/LIMITEDS) N 0 C MICHELE THORNE PHD (AUSTIN) N 0 C MICHELE THORNE PHD (INDY) N 0 C THUY "AVA" LE (TESTING ONLY) N 0 C FORT WAYNE NEUROLOGICAL CTR (ADULTS) N 0 C THE JEAN CLINIC,LLC N 0 C THE JEAN CLINIC,LLC (ANDERSON) N 0 C THE JEAN CLINIC,LLC (A-LIMITED) N 0 C THE JEAN CLINIC,LLC INDY -PFS N 0 C THE JEAN CLINIC,LLC PFS -A N 0 C THE JEAN CLINIC, LLC (FORT WAYNE) N 0 C THE JEAN CLINIC, LLC (FW-LIMITED) N 0 C THE JEAN CLINIC, LLC PFS-FW N 0 C MELISSA UMALI, PSY.D.(E) N 0 C THOMAS E. HOLSWORTH, PH.D., HSPP N 0 C WITHAM HEALTH SERVICES (ECHOS) N 0 C WITHAM HEALTH SERVICES (LABS) N 0 C WITHAM HEALTH SERVICES (XRAYS) N 0 C WITHAM HEALTH SERVICES (PFS/DLCO) N 0 C ADVANCED CARDIOVASCULAR INSTITUTE (ECHO/TET) N 0 C ADVANCED CARDIOVASCULAR INSTITUTE (DOPPLERS) N 0 C SOUND HEARING SOLUTIONS N 0 C BURGETT EYE CARE N 0 C DOCTORS HEARING CARE N 0 C THE HEARING CLINIC N 0 C BALL STATE UNIVERSITY AUDIOLOGY CLINIC N 0 C EVANSVILLE HEART CENTER (ECHOS) N 0 C BHARAT PITHADIA M.D. N 0 C ST JOSEPH REGIONAL - PLYMOUTH (PFS) N 0 C ST JOSEPH REGIONAL - PLYMOUTH (XR) N 0 C ST JOSEPH REGIONAL - PLYMOUTH (MUGA) N 0 C ST JOSEPH REGIONAL - PLYMOUTH (LABS/EKG) N 0 C JARED OUTCALT, PH.D. N 0 C KATHRYN HULS, PSY.D. N 0 C HEATH FERVIDA PSYD (WARSAW) N 0 C ANN CAROL SINGLER, PH.D. N 0 C PAUL KEVIN BOLINSKEY, PH.D., HSPP N 0 C DUNCAN PSYCHOLOGICAL SERVICES (WASH) N 0 C DUNCAN PSYCHOLOGICAL SERVICES (VIN) N 0 C PROVIDENCE MEDICAL GROUP (ECHOS) N 0 C ST MARY MEDICAL CENTER (XRAY) N 0 C ST MARY MEDICAL CENTER (PULM) N 0 C VALPARAISO HEALTH CENTER OF ST MARY MEDICAL CTR N 0 C VALPARAISO HEALTH CENTER OF ST MARY MEDICAL CTR N 0 C ERIN KENNEDY, PH.D. N 0 C INDIANA EAR(SB) N 0 C INDIANA EAR (FW) N 0 C ANDREW MILLER, PSY.D. (FW) N 0 C KURT JACOBS, D.O. N 0 C KURT JACOBS, D.O. (PFS & LIMITED) N 0 C KURT JACOBS, D.O.(MADISON) N 0 C KURT JACOBS, D.O. MADISON (PFS & LIMITED) N 0 C ERIC GUDAN, PSY.D. N 0 C PAUL LYSAKER, PH.D. N 0 (b) (6) C STEVEN L MARLOW, PH.D. (b) (6) N 0 C UNION ASSOCIATED PHYSICIANS CLINIC LLC N 0 C CARMEL NEUROPSYCHOLOGY SERVICES N 0 C AMY MEYER, PSY.D.(CON) N 0 C AMY MEYER, PSY.D.(GR) N 0 C RESOLUTIONS PSYCHOLOGICAL SERVICES N 0 C JOHN CADWALLADER, PSY.D. N 0 C CARA PRATT, MA (TX ONLY) N 0 C DLH COUNSELING AND CONSULTING LLC N 0 C NORTH CENTRAL CARDIOVASCULAR SPECIALISTS N 0 C OPHTHALMOLOGY CONSULTANTS OF FT WAYNE N 0 C OPHTHALMOLOGY CONSULTANTS OF FT WAYNE (OPT) N 0 C SIRA IMAGING CENTER LLC N 0 C BUSINESS HEALTH PLUS N 0 C BUSINESS HEALTH PLUS (PFS/XRAY) N 0 C RACHEL SCHALLER, CCC-SLP N 0 C RACHEL SCHALLER, CCC-SLP (MARION) N 0 C WELLCARE (INDY) N 0 C WELLCARE (INDY-/PFS-LIMITED) N 0 C WELLCARE (LAF) N 0 C WELLCARE (LAF-PFS/X-RAYS, LIMITED) N 0 C WELLCARE (EVANSVILLE) N 0 C WELLCARE (E-PFS/X-RAY-LIMITED) N 0 C DECATUR CO MEM HOSPITAL (PUL) N 0 C INDEPENDENT DISABILITY EXAMINERS & ASSOCIATES (MU) N 0 C INDEPENDENT DISABILITY EXAMINERS & ASSOC(MU-PFS) N 0 C IDEA (MARION) N 0 C IDEA (MARION-PFS) N 0 C IDEA (FT WAYNE) N 0 C IDEA (FW-PFS) N 0 C BRENDA F. HARRIS, SLP N 0 C MACHA FAMILY EYE CARE, PC N 0 C FOUNTAIN SQUARE EYE CARE N 0 C MATTHEW HARKIN OD N 0 C EYEWORKS N 0 C GREGORY L. WILSON, O.D. N 0 C HARMONY EYECARE N 0 C GAILMARD EYE CENTER N 0 C DAN R HOST, O.D. N 0 C LONGE VISION CENTER N 0 C MIDWEST EYE CONSULTANTS (K) N 0 C ABOITE FAMILY EYECARE CENTER N 0 C CHARLES H. RUTAN OD N 0 C CHARLES H. RUTAN OD (TERRE HAUTE) N 0 C THE EYE PLACE, INC. N 0 C MOSES EYECARE CENTERS (G) N 0 C MOSES EYECARE CENTERS (M) N 0 C YOUR FAMILY & HEART CARE CENTER N 0 C YOUR FAMILY & HEART CARE CENTER N 0 C FOCUS AUDIOLOGY & HEARING SVCES N 0 C GREGORY M. FRENCH, M.D. N 0 C GREGORY M. FRENCH, M.D. N 0 C ROBBI CRAIN, PSY.D., HSPP N 0 C JESSICA NEUKAM-HELMS PSY.D N 0 C OWENS OPTOMETRY, INC. N 0 C DR SORAJ ARORA N 0 C DR SORAJ ARORA (PFS/ANCILLARIES) N 0 C DR SORAJ ARORA (ECHOS) N 0 C SHELEY THERAPY SERVICES N 0 C CRAIG FENIMORE, O.D. N 0 C MICHAEL D. PISANO, PH.D. (I-DT) N 0 C ST MARYS MEDICAL CENTER (E-XRAY/LABS) N 0 C ST MARYS MEDICAL CENTER (E-PUL) N 0 (b) (6) C ST MARYS MEDICAL CENTER (E-ABG) N 0 C PURDUE UNIVERSITY AUDIOLOGY CLINIC (b) (6) N 0 C EASTER SEALS REHABILITATION CENTER N 0 C DAVID FINGERHUT, PH.D. (AUSTIN) N 0 C DAVID FINGERHUT, PH.D. (INDY) N 0 C CRAIG S. CABEZAS, PH.D. N 0 C CRAIG S. CABEZAS, PH.D. N 0 C ELIZABETH S. RAYL, PH.D. N 0 C DR ARTHUR KUPERSMITH N 0 C JESSICA HUETT, PSY.D. N 0 C JENNIFER M HATFIELD, SLP (VALPO) N 0 C JENNIFER M HATFIELD, SLP (M) N 0 C JENNIFER M HATFIELD, SLP (E) N 0 C JOHN A CONSTANTINE PHD HSPP N 0 C LYNETTE SCHULTZ, PSY.D. (GARY) N 0 C COMMUNICATION AND READING EXCELLENCE, PC N 0 C ERICKA SWANSON, PSY.D. N 0 C 180 MEDICAL IMAGING, LLC N 0 C FOCUS EYE CARE CENTER N 0 C MELISSA SPRINKLE, PSY.D. N 0 C CHAD EDWARDS, PH.D., HSPP N 0 C TRI-STATE OCCUPATIONAL (SCOTTSBURG) N 0 C TRI-STATE OCCUPATIONAL (SCOTTSBURG-PFS) N 0 C PRO MEDICAL MIDWEST (BLOOMINGTON) N 0 C PRO MEDICAL MIDWEST (LAWRENCEBURG) N 0 C PRO MEDICAL MIDWEST (TH) N 0 C DR. ALAN STAGE N 0 C KIMBERLY M MARTIN PSYD N 0 C REVATHI BINGI PHD N 0 C RUTH REEVES, PSY.D. N 0 C INTERACTIVE SCHOOL THERAPY LLC N 0 C ASSC PHYSICIANS OF IN (C) N 0 C ASSOC. PHYSICIANS OF IN (C-PFS/XRAY) N 0 C ASSOC. PHYSICIANS OF IN (G) N 0 C ASSOC. PHYSICIANS OF IN (G-XRAY) N 0 C NEIL WATKINS M.D. N 0 C JAMILA PERRY RICHMOND, MA, CCC-SLP N 0 C JODEE GRAHAM SLP-CCC-M.S N 0 C PROFESSIONAL INTERPRETERS FOR THE DEAF N 0 C DEAF COMMUNITY SERVICES N 0 C DEAF SERVICES, INC. N 0 C LUNA LANGUAGE SERVICES N 0 State of Iowa DDS - 2017 Consultative Examination Providers

CARDIOLOGISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB GENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900 DIAGNOSTIC SERVICES 1200 PLEASANT ST E 318 DES MOINES IA 50309 515 241 6111 MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000 CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702

GENERAL PRACTITIONEERS NAME ADDR1 CITY ST ZIP AREA EX NUMB BURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400 KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714 ALAN SCHER MD (b) (6) ALGONA IA 50511 515 295 3761 ANKENY WALK IN CLINIC 225 SE ORALABOR RD STE 3 ANKENY IA 50023 515 964 1340 MEDIX OCCUPATIONAL HEALTH 1824 SW WHITE BIRCH CIR ANKENY IA 50023 515 964 9003 ANTHON MERCY MEDICAL CLINIC 307 E MAIN ST ANTHON IA 51004 712 373 5711 MEDIX OCCUPATIONAL HEALTH 886 TANGLEFOOT LN BETTENDORF IA 52722 515 964 9903 BROOKLYN MEDICAL CLINIC 128 JACKSON ST BROOKLYN IA 52211 641 522 7221 BRIAN ALLEN DO (b) (6) CEDAR FALLS IA 50613 507 450 995 MERCY CARE MEDICAL DISTRICT 600 7TH ST SE STE 100 CEDAR RAPIDS IA 52401 319 363 2929 MEDIX OCCUPATIONAL HEALTH 1520 MIDLAND CT NE STE 200 CEDAR RAPIDS IA 52402 515 964 9003 VAL O LYONS MD (b) (6) CHARLES CITY IA 50616 641 257 4309 LEE MERRITT MD (b) (6) CHARLES CITY IA 50616 641 257 4309 CHARLES CITY FAMILY HEALTH CENTER 1501 S MAIN STE 1 CHARLES CITY IA 50616 641 228 5151 MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333 QUAD CITY OCCUPTATIONAL HEALTH 1820 W 3RD ST DAVENPORT IA 52802 563 322 2103 GENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900 GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140 CRAWFORD COUNTY CLINIC 1820 HIGHWAY 30 E DENISON IA 51442 712 263 6116 DENISON FAMILY HEALTH 2540 N AVE DENISON IA 51442 712 263 3033 BROADLAWNS GERIATRIC MEDICINE AND MEMORY CENTER 1801 HICKMAN RD DES MOINES IA 50314 515 282 5700 IOWA ARTHRITIS CENTER 8421 PLUM DR DES MOINES IA 50322 515 270 7222 FINLEY OCCUPATIONAL HEALTH 1665 EMBASSY WEST DR STE 200 DUBUQUE IA 52002 563 585 1290 BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400 MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904 BURLINGTON NEUROLOGY & SLEEP CLINIC 5409 AVE O STE 108 FORT MADISON IA 52627 319 754 4400 BRET HEILESON MD (b) (6) HARLAN IA 51537 712 755 5130 IDA GROVE FAMILY HEALTH CENTER 101 E 2ND ST IDA GROVE IA 51445 712 364 2300 BURLINGTON NEUROLOGY & SLEEP CLINIC 1425 MORGAN ST KEOKUK IA 52632 319 754 4400 BRIAN ALLEN DO (b) (6) LANCASTER WI 53813 507 450 995 MAQUOKETA FAMILY CLINIC 206 N ARCADE MAQUOKETA IA 52060 563 652 6711 MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191 BRIAN ALLEN DO 423 4TH ST SW STE A MASON CITY IA 50401 641 450 995 MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937 BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400 UNITYPOINT OCCUPATIONAL MEDICINE 1616 CEDAR ST UPPER LEVEL MUSCATINE IA 52761 563 262 4120 MIDTOWN MEDICAL GROUP 115 S 8TH ST NEBRASKA CITY NE 68410 402 558 1440 MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471 NEWTON CLINIC 300 N 4TH AVE E STE 200 NEWTON IA 50208 641 792 2112 UI HEALTHWORKS 3 LIONS DR NORTH LIBERTY IA 52317 319 356 3335 SAMUEL MOESSNER MD 1941 S 42ND ST STE 404 OMAHA NE 68105 402 206 5820 MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440 MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090 BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400 JACK BRINDLEY MD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 680 660 PELLA REGIONAL HEALTH CLINIC 920 N QUINCY ST OTTUMWA IA 52501 641 455 5206 PAULLINA FAMILY MEDICINE CLINIC 108 E GROESBECK ST PAULLINA IA 51046 712 448 2126 COUNTRYSIDE MEDICAL CLINIC LLC 1959 200TH ST RED OAK IA 51566 712 629 40 DOUGLAS MARTIN MD (b) (6) SIOUX CITY IA 51109 712 224 4300 CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633 MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 5 SOUTH SIOUX CITY NE 68776 402 558 1440 BRIAN ALLEN DO (b) (6) SPIRIT LAKE IA 51301 507 450 995 UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030 SUTHERLAND MERCY MEDICAL CLINIC 108 W 2ND ST SUTHERLAND IA 51058 712 446 2567 VILLISCA FAMILY HEALTH CENTER 309 S 5TH AVE VILLISCA IA 50864 712 826 3003 NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112 JOSEPH LATELLA DO (b) (6) WEBSTER CITY IA 50595 515 832 2911 BURLINGTON NEUROLOGY & SLEEP CLINIC 1225 S GEAR AVE STE 153 WEST BURLINGTON IA 52655 319 754 4400 BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622 BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800 MERCY OCCUPATIONAL HEALTH 1055 JORDAN CREEK PKWY STE 100 WEST DES MOINES IA 50266 515 358 5950 MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

LAB NAME ADDR1 CITY ST ZIP AREA EX NUMB BURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400 KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714 MEDIX OCCUPATIONAL HEALTH 1824 SW WHITE BIRCH CIR ANKENY IA 50023 515 964 9003 ANTHON MERCY MEDICAL CLINIC 307 E MAIN ST ANTHON IA 51004 712 373 5711 MEDIX OCCUPATIONAL HEALTH 886 TANGLEFOOT LN BETTENDORF IA 52722 515 964 9903 ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581 SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 268 3000 MERCY CARE SECOND AVENUE 1444 2ND AVE SE CEDAR RAPIDS IA 52403 319 363 2929 WELAND CLINICAL LABORATORIES 1911 1ST AVE SE CEDAR RAPIDS IA 52406 319 366 1503 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 8129 MEDIX OCCUPATIONAL HEALTH 1520 MIDLAND CT NE STE 200 CEDAR RAPIDS IA 52402 515 964 9003 MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111 MERCY MEDICAL CENTER 19876 SAINT JOSEPH DR CENTERVILLE IA 52544 641 856 8684 CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101 CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176 ALEGENT HEALTH MERCY HOSPITAL 603 ROSARY DR CORNING IA 50841 641 322 3121 WAYNE COUNTY HOSPITAL 417 S EAST ST CORYDON IA 50060 641 872 2260 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600 MERCY HOSPITAL - VASCULAR LAB 800 MERCY DR COUNCIL BLUFFS IA 51502 712 328 5000 GENESIS HEALTH GROUP 1520 W 53RD ST STE 1 DAVENPORT IA 52806 563 421 4900 GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200 GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140 CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2667 CRAWFORD COUNTY CLINIC 1820 HIGHWAY 30 E DENISON IA 51442 712 263 6116 MERCY PEDIATRIC CLINIC 330 LAUREL ST STE 2100 DES MOINES IA 50306 515 643 8611 DIAGNOSTIC SERVICES 1200 PLEASANT ST E 318 DES MOINES IA 50309 515 241 6111 FINLEY HOSPITAL (RESPIRATORY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 563 245 7000 BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400 MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904 GUTHRIE COUNTY HOSPITAL 710 N 12TH ST GUTHRIE CENTER IA 50115 641 332 2201 MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161 IDA GROVE FAMILY HEALTH CENTER 101 E 2ND ST IDA GROVE IA 51445 712 364 2300 ENT MEDICAL SERVICES 2615 NORTHGATE DR IOWA CITY IA 52245 319 351 5680 MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300 KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151 FLOYD VALLEY HOSPITAL 714 LINCOLN ST NE LEMARS IA 51031 712 546 3394 MAQUOKETA FAMILY CLINIC 206 N ARCADE MAQUOKETA IA 52060 563 652 6711 MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056 MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000 MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937 BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400 HENRY COUNTY HEALTH CENTER 407 S WHITE ST MOUNT PLEASANT IA 52641 319 385 3141 UNITYPOINT TRINITY HOSPITAL - MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100 MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471 SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 791 4310 MERCY HOSPITAL OF FRANCISCAN SISTERS 201 8TH AVE SE OELWEIN IA 50662 319 283 6000 MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440 BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311 MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090 MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431 BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400 PELLA REGIONAL HEALTH CLINIC 920 N QUINCY ST OTTUMWA IA 52501 641 455 5206 PAULLINA FAMILY MEDICINE CLINIC 108 E GROESBECK ST PAULLINA IA 51046 712 448 2126 PELLA REGIONAL HEALTH CENTER 404 JEFFERSON ST PELLA IA 50219 641 628 3150 HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000 SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211 SIOUX CENTER COMMUNITY HOSPITAL 1101 9TH ST SE SIOUX CENTER IA 51250 712 722 1271 ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979 MERCY MEDICAL CENTER 801 5TH ST SIOUX CITY IA 51101 800 284 7231 CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702 DOUGLAS MARTIN MD (b) (6) SIOUX CITY IA 51109 712 224 4300 PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901 CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633 BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030 UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030 SUTHERLAND MERCY MEDICAL CLINIC 108 W 2ND ST SUTHERLAND IA 51058 712 446 2567 VILLISCA FAMILY HEALTH CENTER 309 S 5TH AVE VILLISCA IA 50864 712 826 3003 COVENANT MEDICAL CENTER 3421 W 9TH ST WATERLOO IA 50702 319 272 8000 ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50702 319 235 5100 NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112 JOSEPH LATELLA DO (b) (6) WEBSTER CITY IA 50595 515 832 2911 GREAT RIVER MED CENTER 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590 BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622 BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800 MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

NEUROLOGISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB BURLINGTON NEUROLOGY & SLEEP CLINIC 6580 165ST ALBIA IA 52531 319 754 4400 RUAN NEUROLOGY - EAST TOWER 1111 6TH AVE E TOWER STE A100 DES MOINES IA 50314 515 358 11 BURLINGTON NEUROLOGY & SLEEP CLINIC 2000 S MAIN FAIRFIELD IA 52556 319 754 4400 BURLINGTON NEUROLOGY & SLEEP CLINIC 5409 AVE O STE 108 FORT MADISON IA 52627 319 754 4400 BURLINGTON NEUROLOGY & SLEEP CLINIC 1425 MORGAN ST KEOKUK IA 52632 319 754 4400 BURLINGTON NEUROLOGY & SLEEP CLINIC 407 S WHITE ST MOUNT PLEASANT IA 52641 319 754 4400 GOLDNER COOPER COTTON SUNDELL FRANEL 8901 W DODGE RD STE 210 OMAHA NE 68114 402 354 2000 BURLINGTON NEUROLOGY & SLEEP CLINIC 1207 N JEFFERSON ST OTTUMWA IA 52501 319 754 4400 BURLINGTON NEUROLOGY & SLEEP CLINIC 1225 S GEAR AVE STE 153 WEST BURLINGTON IA 52655 319 754 4400

ORTHOPEDISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333 MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191

OTOLARYNGOLOGISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB AUDIOLOGICAL SERVICES INC 712 SIMON AVE STE A CARROLL IA 51401 712 792 5933 WELLENDORF ENT PC 405 S CLARK ST STE 215 CARROLL IA 51401 712 792 4368 PHYSICIANS CLINIC OF IOWA - ENT 202 10TH ST SE CEDAR RAPIDS IA 52401 319 399 2022 AUDIOLOGICAL SERVICES INC 1200 N 7TH ST CHARITON IA 50049 712 623 4802 AUDIOLOGICAL SERVICES INC 319 W ADAMS CRESTON IA 50801 641 782 2494 EAR NOSE & THROAT CONSULTANTS 101 TOWER RD STE 120 DAKOTA DUNES SD 57049 605 217 4320 QUAD CITIES AUDIOLOGY CONSULTANTS 2215 E 52ND ST STE 2 DAVENPORT IA 52807 563 355 7712 IOWA HEAD & NECK ASSOCIATES 3901 INGERSOLL AVE DES MOINES IA 50312 515 274 9136 IOWA EAR CENTER 12499 UNIVERSITY AVE STE 200 DES MOINES IA 50325 515 418 9960 DUBUQUE ENT 310 N GRANDVIEW AVE DUBUQUE IA 52001 563 588 506 LEOPOLDO DELUCCA MD 804 S KENYON RD STE 200 FORT DODGE IA 50501 515 576 5000 ENT MEDICAL SERVICES 2615 NORTHGATE DR IOWA CITY IA 52245 319 351 5680 UIH DEPARTMENT OF OTOLARYNGOLOGY 200 HAWKINS RD IOWA CITY IA 52242 319 384 8092 CHILDSERVE CENTER 5406 MERLE HAY RD JOHNSTON IA 50131 515 727 1561 WOLFE CLINIC - AUDIOLOGY 309 E CHURCH ST MARSHALLTOWN IA 50158 866 642 8142 MASON CITY CLINIC - ENT 250 S CRESCENT DR MASON CITY IA 50401 641 494 5380 AUDIOLOGY CONSULTANTS 3426 N PORT DR STE 500 MUSCATINE IA 52761 563 264 9406 BOYSTOWN NATIONAL HOSPITAL 555 N 30TH ST OMAHA NE 68131 402 452 5059 FAMILY EAR NOSE & THROAT CLINIC 6751 N 72ND ST STE 207 OMAHA NE 68122 402 572 3165 VISION CARE CLINIC 721 10TH ST ONAWA IA 51040 712 423 2737 MOORE HEARING CLINIC 1317 N COURT ST OTTUMWA IA 52501 641 683 3277 NORTHWEST IOWA EAR NOSE & THROAT 920 N GRAND AVE SPENCER IA 51301 712 262 8120 ANN SPRINGER SPEECH THERAPIST (b) (6) WATERLOO IA 50702 319 235 5100 BLACK HAWK HEARING AID CENTER 3138 KIMBALL AVE WATERLOO IA 50702 319 234 4360 COVENANT CLINIC - ENT CENTER 2710 ST FRANCIS DR STE 411 WATERLOO IA 50702 319 272 5805 GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590 IOWA CLINIC ENT 5950 UNIVERSITY AVE STE 265 WEST DES MOINES IA 50266 515 875 9456

PEDIATRICIANS NAME ADDR1 CITY ST ZIP AREA EX NUMB MERCY PEDIATRIC CLINIC 330 LAUREL ST STE 2100 DES MOINES IA 50306 515 643 8611 RIVER HILLS PEDIATRICS 931 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 3000 PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901 JOSEPH LATELLA DO (b) (6) WEBSTER CITY IA 50595 515 832 2911

PHYSICAL THERAPISTS 21ST CENTURY REHAB 612 8TH ST SW ALTOONA IA 50009 515 967 4124 MARY GREELEY REHAB & WELLNESS 1015 DUFF AVE AMES IA 50010 515 239 6770 MARY GREELEY REHAB & WELLNESS 1111 DUFF AVE AMES IA 50010 515 239 6770 WAPSI PHYSICAL THERAPY 315 E MAIN ST ANAMOSA IA 52205 319 462 6882 ATHLETICO PHYSICAL THERAPY 2525 N ANKENY BLVD STE 101 ANKENY IA 50021 515 965 4594 EXCEL PHYSICAL THERAPY 309 N ANKENY BLVD STE 2 ANKENY IA 50021 515 964 2559 MERCY NORTH PHYSICAL THERAPY 800 E 1ST ST STE W270 ANKENY IA 50021 515 643 7555 AUDUBON COUNTY MEMORIAL HOSPITAL 515 PACIFIC AVE AUDUBON IA 50025 712 563 2611 ATHLETICO PHYSICAL THERAPY 509 13TH ST STE B BELLE PLAINE IA 52208 319 434 6150 GENESIS OUTPATIENT REHABILITATION 4710 DEVILS GLEN RD STE 100 BETTENDORF IA 52722 563 421 3460 CAMANCHE PHYSICAL THERAPY 1427 S WASHINGTON BLVD CAMANCHE IA 52730 563 259 4440 21ST CENTURY REHAB 125 N 1ST ST CARLISLE IA 50047 515 989 100 ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581 ATHLETICO PHYSICAL THERAPY 1710 W 1ST ST STE D CEDAR FALLS IA 50613 319 273 8988 SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 272 2260 ATHLETICO PHYSICAL THERAPY 3720 QUEEN CT SW STE 1 CEDAR RAPIDS IA 52404 319 364 300 LINN COUNTY PHYSICAL THERAPY 1825 29TH ST NE STE C CEDAR RAPIDS IA 52402 319 362 6994 MERCY PHYSICAL REHABILITATION 5264 COUNCIL ST NE CEDAR RAPIDS IA 52402 319 861 7778 MERCY PHYSICAL REHABILITATION 701 10TH ST SE 4TH FLOOR CEDAR RAPIDS IA 52403 319 861 7778 MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111 TRESEMER PHYSICAL THERAPY 612 E FRANKLIN ST CENTERVILLE IA 52544 641 856 2515 CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101 SPORTS REHAB & PROFESSIONAL THERAPY ASSOC 1101 N 2ND ST STE 1 CHEROKEE IA 51012 712 225 3344 ATHLETICO PHYSICAL THERAPY 7 S 8TH ST STE C CLEAR LAKE IA 50428 641 357 1003 ADVANCED PHYSICAL THERAPY 404 S 1ST ST CLINTON IA 52732 563 243 4301 MIDWEST PHYSICAL THERAPY 1647 LINCOLN WAY CLINTON IA 52732 563 242 2900 ROCK VALLEY PHYSICAL THERAPY 2635 LINCOLN WAY STE C CLINTON IA 52372 563 243 8324 HOPP PHYSICAL THERAPY 201 W BROADWAY COUNCIL BLUFFS IA 51503 712 329 9419 GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 7091 PHYSICAL THERAPY CENTER 1747 E 54TH ST DAVENPORT IA 52806 563 355 3867 QUAD CITY PHYSICAL THERAPY & SPINE 5254 UTICA RIDGE RD DAVENPORT IA 52807 563 359 3799 ROCK VALLEY PHYSICAL THERAPY 1700 DIVISION ST STE 200 DAVENPORT IA 52804 563 324 2263 WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 382 2911 INTEGRATED PT & SPORTS MEDICINE 1515 LINDEN ST STE 101 DES MOINES IA 50309 515 288 569 KINETIC EDGE PHYSICAL THERAPY 516 3RD ST STE 100 DES MOINES IA 50309 515 309 4706 DUBUQUE PHYSICAL THERAPY 2300 JOHN F KENNEDY RD DUBUQUE IA 52002 563 588 3891 PHYSICAL THERAPY SOLUTIONS 1129 11TH ST SE STE A DYERSVILLE IA 52040 563 875 8615 SALVO PHYSICAL THERAPY 1158 EDGINGTON AVE ELDORA IA 50627 641 939 7311 PALO ALTO COUNTY HOSPITAL 3201 W 1ST ST EMMETSBURG IA 50536 712 852 5500 TRINITY REGIONAL MEDICAL CENTER 802 KENYON RD FORT DODGE IA 50501 515 574 6900 21ST CENTURY REHAB 270 SW 1ST ST STE H GRIMES IA 50111 515 986 9667 ATHLETICO PHYSICAL THERAPY 1451 GATEWAY CIR STE 500 GRIMES IA 50111 515 986 5190 MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161 COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100 HUXLEY PHYSICAL THERAPY 408 CAMPUS DR STE B HUXLEY IA 50124 515 597 3726 INDIANOLA PHYSICAL THERAPY 1507 N 1ST ST INDIANOLA IA 50125 515 961 7435 PHYSIOTHERAPY ASSOCIATES 1555 S 1ST AVE IOWA CITY IA 52240 319 248 6800 PROGRESSIVE REHABILITATION ASSOCIATES 540 E JEFFERSON ST STE 302 IOWA CITY IA 52245 319 339 3611 HANSEN FAMILY HOSPITAL 920 S OAK ST IOWA FALLS IA 50126 641 648 7055 GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114 VAN BUREN COUNTY HOSPITAL 304 FRANKLIN ST KEOSAUQUA IA 52565 319 293 3171 KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151 LAKE MILLS PHYSICAL THERAPY 115 N MILL ST LAKE MILLS IA 50450 641 592 3500 FLOYD VALLEY HOSPITAL 720 LINCOLN ST NE LEMARS IA 51031 712 546 7871 LEMARS PHYSICAL THERAPY 789 HOLTON DR LEMARS IA 51031 712 546 1718 DECATUR COUNTY HOSPITAL 1405 NW CHURCH ST LEON IA 50144 641 446 4871 21ST CENTURY REHAB 209 W 2ND ST MADRID IA 50156 515 795 2427 MARION PHYSICAL THERAPY 999 44TH ST STE 10000 MARION IA 52302 319 373 7311 SPORTSPLUS 32 E MAIN ST MARSHALLTOWN IA 50158 641 753 6636 IOWA PHYSICAL THERAPY 820 W 1ST ST MONTICELLO IA 52310 319 465 4057 INTEGRATED THERAPY SPECIALISTS PC 2109 CEDARWOOD DR STE 100 MUSCATINE IA 52761 563 288 6787 ROCK VALLEY PHYSICAL THERAPY 3605 UNIVERSITY DR STE 2 MUSCATINE IA 52761 563 263 2639 NASHUA CLINIC 80 AMHEARST BLVD STE 400 NASHUA IA 50658 641 435 4133 TWENTY FIRST CENTURY REHAB 640 S 19TH ST NEVADA IA 50201 515 382 7008 KINETIC EDGE PHYSICAL THERAPY 321 E 3RD ST N STE 200 NEWTON IA 50208 641 791 9675 SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 792 1273 ATHLETICO PHYSICAL THERAPY 800 COLONIAL CIR STE 100 NORWALK IA 50211 515 953 1310 MERCY HOSPITAL OF FRANCISCAN SISTERS 201 EIGHTH AVE SE OELWEIN IA 50662 319 283 6100 ORANGE CITY PHYSICAL THERAPY 101 3RD ST NW ORANGE CITY IA 51041 712 707 5050 CLARKE COUNTY HOSPITAL 800 S FILLMORE ST OSCEOLA IA 50213 641 342 2184 PROFESSIONAL PHYSICAL THERAPY SERVICES 123 E JEFFERSON OSCEOLA IA 50213 641 341 1470 KINETIC EDGE PHYSICAL THERAPY 1412 A AVE W STE A OSKALOOSA IA 52577 641 676 3535 MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 672 3100 OTTUMWA REGIONAL HEALTH CENTER 1001 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 3125 SOUTHEAST IOWA PHYSICAL THERAPY SERVICES 115 S WASHINGTON ST OTTUMWA IA 52501 641 682 8171 KINETIC EDGE PHYSICAL THERAPY 604 LIBERTY ST STE 227 PELLA IA 50219 641 621 230 MONTGOMERY COUNTY MEMORIAL HOSPITAL 2301 EASTERN AVE RED OAK IA 51566 712 623 7000 HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000 DISEASE PREVENTION AND WELLNESS CENTER TWO JACK FOSTER DR SHENANDOAH IA 51601 712 246 1230 SIOUX CITY PHYSICAL THERAPY 2802 CASTLES GATE DR SIOUX CITY IA 51106 712 266 707 ST LUKES REHAB - RIVERSIDE CLINIC 4230 WAR EAGLE DR SIOUX CITY IA 51109 712 224 4330 SPENCER MUNICIPAL HOSPITAL 1200 1ST AVE E SPENCER IA 51301 712 264 6189 THOMAS PHYSICAL THERAPY PROFESSIONALS LLC 20 W 6TH ST STE 101 SPENCER IA 51301 712 580 5008 OKOBOJI PHYSICAL THERAPY 1380 LAKE ST SPIRIT LAKE IA 51360 712 336 8404 SPORTS REHAB & PHYSICAL THERAPY 315 W 5TH ST STORM LAKE IA 50588 712 732 7724 MARY GREELEY REHAB & WELLNESS 812 ELM AVE STORY CITY IA 50248 515 733 5129 PROGRESSIVE REHABILITATION ASSOCIATES 120 E 5TH ST TIPTON IA 52772 563 886 3421 VIRGINIA GAY HOSPITAL 502 N 9TH AVE VINTON IA 52349 319 472 6372 ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 319 235 5294 COVENANT MEDICAL CENTER EDI 3421 W 9TH ST WATERLOO IA 50702 319 272 2260 ROCK VALLEY PT 815 TOWER PARK DR WATERLOO IA 50701 319 233 6995 TAYLOR PHYSICAL THERAPY 312 9TH ST SW WAVERLY IA 50677 319 352 5644 VAN DIEST MEDICAL CENTER PO BOX 430 WEBSTER CITY IA 50595 515 832 7735 CENTER FOR REHAB SERVICES 1401 W AGENCY RD WEST BURLINGTON IA 52655 319 768 4100 ATHLETICO PHYSICAL THERAPY 800 S 50TH ST STE 103 WEST DES MOINES IA 50266 515 226 1616 CORE PHYSICAL THERAPY 2001 WESTOWN PKWY STE 107 WEST DES MOINES IA 50265 515 440 3439 PROGRESSIVE REHABILITATION ASSOCIATES 518 ELM ST WILLIAMSBURG IA 52361 319 668 9399

PSYCHIATRISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB SOUTHWEST IOWA MENTAL HEALTH CENTER 1500 E 10TH ST ATLANTIC IA 50022 712 243 2606 ALI SAFDAR MD (b) (6) CEDAR RAPIDS IA 52405 319 398 3562

PSYCHOLOGISTS NAME ADDR1 CITY ST ZIP AREA EX NUMB PLAINS AREA MENTAL HEALTH CENTER 109 W STATE ST ALGONA IA 50511 712 546 4624 RAYMOND TIBE PSYD (b) (6) ALTOONA IA 50009 515 279 3266 ARTHUR KONAR PHD PLC 511 DUFF AVE STE 100 AMES IA 50010 515 292 2703 CENTRAL IOWA PSYCHOLOGICAL SERVICES 223 S WALNUT AVE AMES IA 50010 515 233 1122 SOUTHWEST IOWA MENTAL HEALTH CENTER 1500 E 10TH ST ATLANTIC IA 50022 712 243 2606 SARAH HERZBERG PHD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023 REBECKA THOMPKINS PHD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023 JOHN BIGELOW JR PSYD 1500 E 10TH ST ATLANTIC IA 50022 712 250 8023 FAMILY COUNSELING & PSYCHOLOGY CENTER 2485 TECH DR BETTENDORF IA 52722 563 355 1611 COLLIN LODICO PHD 2485 TECH DR BETTENDORF IA 52722 563 355 1611 SUSAN WOOD EDD 2485 TECH DR BETTENDORF IA 52722 563 355 1611 WILLIAM MARTIN JR PHD (b) (6) BOONE IA 50036 515 433 343 PSYCHOLOGICAL CONSULTING & ASSESSMENT 1000 N ROOSEVELT AVE STE 7 BURLINGTON IA 52601 641 629 240 TIMOTHY WAHL PHD 1000 N ROOSEVELT AVE BURLINGTON IA 52601 641 891 8970 PLAINS AREA MENTAL HEALTH CENTER 318 S MAPLE ST STE 1 CARROLL IA 51401 712 546 4624 CONDITT PSYCHOLOGICAL SERVICES 2412 WATERLOO RD CEDAR FALLS IA 50613 319 277 1020 GREGORY HOTSENPILLER MD PHD 1730 1ST AVE NE CEDAR RAPIDS IA 52402 319 365 3993 PAUL SUNDELL PHD 1730 1ST AVE NE CEDAR RAPIDS IA 52402 319 365 3993 CARROLL ROLAND PHD 450 5TH AVE SE 2ND FLOOR CEDAR RAPIDS IA 52401 319 234 7481 ROGER MRAZ PHD 4403 1ST AVE SE ROOM L15 CEDAR RAPIDS IA 52402 319 728 2419 STEPHANIE ANTHONY PHD 373 COLLINS RD NE STE 203 CEDAR RAPIDS IA 52402 319 210 2820 MICHELE MCNEAL 708 J AVE NE STE 205 CEDAR RAPIDS IA 52402 319 551 1556 RANDALL WATKINS 708 J AVE NE STE 205 CEDAR RAPIDS IA 52402 319 430 7466 ROBERT METZGER PSYD (b) (6) CEDAR RAPIDS IA 52402 319 297 3520 MICHAEL MARCH PHD PLLC 700 16TH ST NE STE 201 CEDAR RAPIDS IA 52402 319 364 170 NANNETT ROACH PHD (b) (6) CENTERVILLE IA 52544 641 676 3999 LORNE JOHNSON PSYD (b) (6) CHARLES CITY IA 50616 641 228 6830 PLAINS AREA MENTAL HEALTH CENTER 1231 WEST CEDAR LOOP CHEROKEE IA 51012 712 546 4624 STEPHEN HOLBROOK PSYD 518 S 8TH ST STE 207 CLEAR LAKE IA 50428 641 357 272 JOHN KERAUS PHD (b) (6) CLINTON IA 52732 563 243 5633 JANET DREW PHD 215 6TH AVE S STE 25 CLINTON IA 52732 563 242 9210 ROGER MRAZ PHD 205 E ACCESS RD STE D COLUMBUS JUNCTION IA 52738 319 728 2419 ROSANNA JONES-THURMAN PHD 300 W BROADWAY STE 3 COUNCIL BLUFFS IA 51503 402 715 4321 NICOLE BLAZEK PHD (b) (6) COUNCIL BLUFFS IA 51503 402 208 6315 RUSSELL MOULTON MS (b) (6) CRESTON IA 50801 712 527 2845 PATRICIA BLAKE PHD (b) (6) CRESTON IA 50801 402 769 2121 PSYCHOLOGY ASSOCIATES LTD 4455 E 56TH ST DAVENPORT IA 52807 563 355 2577 ROGER MRAZ PHD (b) (6) DAVENPORT IA 52804 319 728 2419 PSYCHOLOGY HEALTH GROUP 2102 E 38TH ST DAVENPORT IA 52807 563 359 4049 JOSEPH BREITENSTEIN PHD (b) (6) DECORAH IA 52101 563 419 4340 JERALD CATRON PHD 3850 MERLE HAY RD STE 300 DES MOINES IA 50312 515 254 9009 ROBERT STRAIGHT PHD 1000 73RD ST STE 5 DES MOINES IA 50324 515 222 1175 PHILIP ASCHEMAN PHD 7177 HICKMAN RD STE 12 DES MOINES IA 50322 515 253 566 PAUL ASCHEMAN PHD 7177 HICKMAN RD STE 12 DES MOINES IA 50322 515 253 566 TIMOTHY WAHL PHD (b) (6) DES MOINES IA 50319 641 891 8970 MARION HUETTNER PHD 1000 LANGWORTHY DUBUQUE IA 52001 563 584 3441 MARTHA GOULD PHD 1000 LANGWORTHY DUBUQUE IA 52001 563 584 3441 CARROLL ROLAND PHD (b) (6) DUBUQUE IA 52001 319 234 7481 THOMAS ANDEREGG PHD 200 MERCY DR STE 200 DUBUQUE IA 52001 563 582 145 MEDICAL ASSOCIATES CLINIC/PSYCH 200 MERCY DR STE 201 DUBUQUE IA 52001 563 584 3500 DON JOHNSON PSY.D (b) (6) ESTHERVILLE IA 51334 712 362 4093 PSYCHOLOGICAL CONSULTING & ASSESSMENT 112 S COURT FAIRFIELD IA 52556 641 629 240 PLAINS AREA MENTAL HEALTH CENTER 723 1ST AVE S FORT DODGE IA 50501 712 546 4624 DAN L ROGERS PHD 809 CENTRAL AVE STE 300 FORT DODGE IA 50501 515 955 8172 MELANIE PORTER PSYD (b) (6) FORT DODGE IA 50501 515 955 7171 TIMI JORDISON PHD 1728 CENTRAL AVE STE 14 FORT DODGE IA 50501 515 573 3628 JAMES CHESNUTT PSYD 809 CENTRAL AVE STE 300 FORT DODGE IA 50501 515 955 3029 RUSSELL MOULTON MS (b) (6) GLENWOOD IA 51534 712 527 2845 BRIAN STEINER PHD 821 5TH AVE STE 403 GRINNELL IA 50112 641 844 1200 DAVIS PSYCHOLOGICAL SERVICES 1104 5TH AVE GRINNELL IA 50112 641 236 632 ROSANNA JONES-THURMAN PHD (b) (6) HARLAN IA 51537 402 715 4321 PLAINS AREA MENTAL HEALTH CENTER 700 E 2ND ST STE 2 IDA GROVE IA 50588 712 546 4624 COUNSELING & ASSESSMENT SERVICE 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820 GEORGE HARPER PHD 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820 SETH BROWN PHD 515 2ND ST NE INDEPENDENCE IA 50644 319 334 6820 SEASHORE PSYCHOLOGY CLINIC 328 IOWA AVE IOWA CITY IA 52242 319 335 2467 DAVID JOHNSON PHD (b) (6) IOWA CITY IA 52245 319 337 6998 RANDALL WATKINS (b) (6) IOWA CITY IA 52240 319 430 7466 MARVIN DENBURG PHD 3030 NORTHGATE DR STE E IOWA CITY IA 52245 319 337 6483 KATHLEEN KIKENDALL PHD 220 LAFAYETTE ST STE 128 IOWA CITY IA 52240 319 354 8057 DENNIS HARPER PHD (b) (6) IOWA CITY IA 52245 319 351 7542 PATRICK EWING MS (b) (6) KEOKUK IA 52632 319 524 510 TIMOTHY WAHL PHD (b) (6) KNOXVILLE IA 50138 641 891 8970 PLAINS AREA MENTAL HEALTH CENTER 180 10TH ST SE STE 201 LEMARS IA 51031 712 546 4624 PLAINS AREA MENTAL HEALTH CENTER 180 10TH ST SE STE 201 LEMARS IA 51031 712 546 4624 MENTAL HEALTH ASSOCIATES 650 J ST STE 403 LINCOLN NE 68508 402 435 1313 CENTER ASSOCIATES 9 N 4TH AVE MARSHALLTOWN IA 50158 641 752 1585 BRIAN STEINER PHD 16 E MAIN ST STE 200 MARSHALLTOWN IA 50158 641 844 1200 CARROLL ROLAND PHD 103 E STATE ST RM 406 FL 4 MASON CITY IA 50401 319 234 7481 JACKIE JIANG COUNSELING AND EVALUATION 3816 27TH ST MOLINE IL 61256 309 944 7833 TIMOTHY WAHL PHD MUSCATINE COMMUNITY COLLEGE MUSCATINE IA 52761 319 728 2419 MIDTOWN MEDICAL GROUP 115 S 8TH ST NEBRASKA CITY NE 68410 402 558 1440 BRIAN STEINER PHD (b) (6) NEVADA IA 50201 641 844 1200 TIMOTHY WAHL PHD DMACC 600 N 2ND AVE W NEWTON IA 50208 641 629 240 KEVIN KRUMVIEDA PHD (b) (6) NORTH LIBERTY IA 52317 319 665 2137 PSYCHOLOGICAL SERVICES 10506 BURT CIR OMAHA NE 68114 402 493 4444 JOHN ENGLER PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444 EUGENE EGNOSKI PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444 MARY ANN STRIDER PHD 10506 BURT CIR OMAHA NE 68114 402 493 4444 A JAMES FIX PHD 1941 S 42ND ST STE 404 OMAHA NE 68105 402 206 5820 ROSANNA JONES-THURMAN PHD 6818 GROVER ST STE 305 OMAHA NE 68106 402 715 4321 MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440 AMY COREY PHD 440 REGENCY PKWY DR STE 230 OMAHA NE 68114 402 769 2121 PATRICIA BLAKE PHD 440 REGENCY PKWY DR STE 230 OMAHA NE 68114 402 769 2121 JAMES MATHISEN PSYD PC (b) (6) OMAHA NE 68137 402 590 2947 TIMOTHY WAHL PHD (b) (6) OSCEOLA IA 50213 641 629 240 PSYCHOLOGICAL CONSULTING & ASSESSMENT 1710 N MARKET ST OSKALOOSA IA 52577 641 629 240 TIMOTHY WAHL PHD (b) (6) OSKALOOSA IA 52577 641 891 8970 NANNETT ROACH PHD (b) (6) OSKALOOSA IA 52577 641 676 3999 PSYCHOLOGICAL CONSULTING & ASSESSMENT 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 629 240 TIMOTHY WAHL PHD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 891 8970 NANNETT ROACH PHD 15260 TRUMAN ST STE 4 OTTUMWA IA 52501 641 676 3999 PSYCHOLOGICAL CONSULTING & ASSESSMENT 603 MAIN ST PELLA IA 50219 641 629 240 RUSSELL MOULTON MS (b) (6) RED OAK IA 51566 712 527 2845 LORI O'DELL MCCOLLUM PHD 2100 18TH AVE STE 6 ROCK ISLAND IL 61201 309 788 730 DEREK GRIMMELL PHD 2100 18TH AVE STE 6 ROCK ISLAND IL 61201 309 788 730 CREATIVE LIVING CENTER 1905 10TH ST ROCK VALLEY IA 51247 712 476 5245 PLAINS AREA MENTAL HEALTH CENTER 105 N 18TH AVE SHELDON IA 51201 712 546 4624 RUSSELL MOULTON MS (b) (6) SHENANDOAH IA 51601 712 527 2845 MENTAL HEALTH ASSOCIATES 2212 PIERCE ST STE 100 SIOUX CITY IA 51104 712 255 8323 ASSOCIATES FOR PSYCH AND THERAPY SERVICES 1551 INDIAN HILLS DR STE 221 SIOUX CITY IA 51104 712 252 1473 SUZANNE KEIZER PSYD 4301 SERGEANT RD STE 210 SIOUX CITY IA 51106 712 276 3296 CROSSROADS PSYCHOLOGY CENTER 102 E MAIN ST SOLON IA 52333 319 359 6137 MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 8 SOUTH SIOUX CITY NE 68776 402 558 1440 CARROLL ROLAND PHD (b) (6) SPENCER IA 51301 319 234 7481 PLAINS AREA MENTAL HEALTH CENTER 728 ERIE ST STORM LAKE IA 50588 712 546 4624 CAL J SEDA PC (b) (6) URBANDALE IA 50322 515 270 1344 EVA CHRISTIANSEN PHD (b) (6) URBANDALE IA 50322 515 274 4006 CHARLENE BELL EDD 7177 HICKMAN RD STE 12 URBANDALE IA 50322 515 253 566 ROGER MRAZ PHD (b) (6) WASHINGTON IA 52353 319 728 2419 CARROLL ROLAND PHD (b) (6) WATERLOO IA 50701 319 234 7481 JOHN WILLIAMS PHD (b) (6) WATERLOO IA 50701 319 232 2086 CHRISTINE GUEVARA PHD 1425 W 5TH ST STE 1 WATERLOO IA 50702 319 883 9811 CENTRAL IOWA PSYCHOLOGICAL SERVICES 3737 WOODLAND AVE STE 415 WEST DES MOINES IA 50266 515 222 1999 RANDAL DAVID REYNOLDS PHD 4401 WESTOWN PKWY STE 309 WEST DES MOINES IA 50266 515 440 3804 CATALINA D'ACHIARDI-RESSLER PHD 1045 76TH ST STE 3030 WEST DES MOINES IA 50266 515 777 3388

PULMONARY FUNCTION STUDIES CASS COUNTY MEMORIAL HOSPITAL 1501 E 10TH ST ATLANTIC IA 50022 712 243 7590 MERCY MEDICAL CENTER 701 10TH ST SE CEDAR RAPIDS IA 52403 319 398 6011 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111 MERCY MEDICAL CENTER - NORTH CAMPUS 1410 N 4TH ST CLINTON IA 52732 563 244 5722 CHEST INFECTIOUS DISEASE & CRITICAL CARE ASSOC 1601 NW 114TH ST STE 347 CLIVE IA 50325 515 224 1777 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600 GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 3611 GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200 WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 387 3035 CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2667 FINLEY HOSPITAL (RESPIRATORY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787 UNITYPOINT TRINITY REGIONAL HOSPITAL 802 KENYON RD FORT DODGE IA 50501 515 574 6772 COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100 MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300 GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114 KEOKUK AREA HOSPITAL 1600 MORGAN ST KEOKUK IA 52632 319 526 8769 MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056 MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000 UNITYPOINT TRINITY HOSPITAL - MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100 SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 787 3070 MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440 BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311 MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431 OTTUMWA REGIONAL HEALTH CENTER 1001 PENNSYLVANIA AVE OTTUMWA IA 52501 641 684 2348 SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211 ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979 MERCY MEDICAL CENTER - SCHEDULING 801 5TH ST SIOUX CITY IA 51101 800 284 7231 LAKES REGIONAL HEALTH CARE 2301 HIGHWAY 71 SPIRIT LAKE IA 51360 712 336 8659 BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030 ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50703 319 235 5100 GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590

SPEECH LANGUAGE NAME ADDR1 CITY ST ZIP AREA EX NUMB CHILDSERVE CENTER 1915 PHILADELPHIA ST AMES IA 50010 515 232 7220 BRAATEN HEALTH LLC 3740 UTICA RIDGE RD STE 4 BETTENDORF IA 52722 563 326 1400 GENESIS MEDICAL CENTER - PEDATRIC 2535 MAPLECREST RD STE 23 BETTENDORF IA 52722 563 421 3497 BOONE COUNTY HOSPITAL SPEECH DEPT 1015 UNION ST BOONE IA 50036 515 433 8625 BEVERLY SHERBONDY SLP 828 PARKWAY DR BURLINGTON IA 52601 319 752 2255 UNITYPOINT PRAIRIE PARKWAY 5100 PRAIRIE PARKWAY CEDAR FALLS IA 50613 319 222 2901 MERCY PHYSICAL REHABILITATION 5264 COUNCIL ST NE CEDAR RAPIDS IA 52402 319 861 7778 WITWER CHILDRENS THERAPY CENTER 3245 WILLIAMS PKWY SW CEDAR RAPIDS IA 52404 319 369 8407 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 LINDSEY BRANDHORST MA CCC SLP (b) (6) CEDAR RAPIDS IA 52404 319 350 5468 LORI HUFFMAN SLP (b) (6) CLIVE IA 50325 515 643 9830 GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 7091 WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 387 3031 FINLEY WESTMARK CLINIC 1665 EMBASSY WEST DR DUBUQUE IA 52001 563 557 9955 UNIFIED THERAPY SERVICES INC 4121 PENNSYLVANIA AVE DUBUQUE IA 52002 563 583 4003 MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 4342 WITWER CHILDRENS THERAPY 1079 N CENTER POINT RD HIAWATHA IA 52233 319 369 8001 CHILDSERVE CENTER 5406 MERLE HAY RD JOHNSTON IA 50131 515 727 1561 MERCY MEDICAL CENTER SPEECH THERAPY 1501 4TH ST SW MASON CITY IA 50401 641 428 7498 LAB OF SPEECH LANGUAGE DISORDERS 4239 FARNAM ST STE 509 OMAHA NE 68131 402 551 7338 PAMA BENNETT SLP (b) (6) SIOUX CITY IA 51104 712 490 3206 TREVA GRAVES SLP (b) (6) SPENCER IA 51301 712 363 678 BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030 ANN SPRINGER SPEECH THERAPIST (b) (6) WATERLOO IA 50702 319 235 5100 NORTHERN IOWA THERAPY 1810 4TH ST SW STE 103 WAVERLY IA 50677 319 352 1234 CENTER FOR REHAB SERVICES 1401 W AGENCY RD WEST BURLINGTON IA 52655 319 768 4100 CENTRAL REHABILITATION LTD 950 OFFICE PARK RD STE 100 WEST DES MOINES IA 50265 515 224 979

TREADMILL STRESS TEST NAME ADDR1 CITY ST ZIP AREA EX NUMB ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111 CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600 MERCY HOSPITAL - VASCULAR LAB 800 MERCY DR COUNCIL BLUFFS IA 51502 712 328 5000 GREATER REGIONAL MEDICAL CENTER 1700 W TOWNLINE ST CRESTON IA 50801 641 782 3611 GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200 MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161 MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300 MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5056 MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000 SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 7211 CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702 BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030 GREAT RIVER MED CT SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590

VISION EXAMS NAME ADDR1 CITY ST ZIP AREA EX NUMB MCFARLAND EYE CENTER 1128 DUFF AVE AMES IA 50010 515 239 4460 WOLFE CLINIC 2020 PHILADELPHIA ST AMES IA 50010 515 232 2450 EYE SURGEONS ASSOCIATES 777 TANGLEFOOT LN BETTENDORF IA 52722 563 323 2020 BOONE VISION CENTER 621 STORY ST BOONE IA 50036 515 432 2973 FAMILY EYE CARE 90 MAIN AVE N BRITT IA 50423 641 843 3841 SLIWINSKI FAMILY EYECARE PC 3031 FLINT HILLS DR BURLINGTON IA 52601 319 754 5518 CARROLL EYE CARE ASSOCIATES 805 N MAIN CARROLL IA 51401 712 792 9687 WOLFE CLINIC 516 S DIVISION ST CEDAR FALLS IA 50613 800 542 7956 IOWA EYE CENTER 1650 1ST AVE NE CEDAR RAPIDS IA 52402 319 362 3937 CHILDRENS EYE CENTER 4207 GLASS RD NE CEDAR RAPIDS IA 52402 319 366 4455 WENDELL STOELTING OD PC (b) (6) CHEROKEE IA 51012 712 225 3822 MIDWEST VISION CLINIC 425 S 2ND ST CLINTON IA 52732 563 242 223 MID-WEST EYE CARE INC 715 HARMONY 3RD FL COUNCIL BLUFFS IA 51503 712 388 2600 FAMILY VISION CENTER 807 N SUMNER CRESTON IA 50801 641 782 2111 BRUENING EYE SPECIALISTS 101 TOWER RD STE 300 DAKOTA DUNES SD 57049 605 217 4500 VIRDI EYE CLINIC 4624 PROGRESS DR STE C DAVENPORT IA 52807 563 359 3357 MEEHAN AND SCHWARTZ OD PLC (b) (6) DECORAH IA 52101 563 382 4279 MEDICAL ASSOCIATES CLINIC - WEST 1500 ASSOCIATES DR DUBUQUE IA 52002 563 584 3207 DUBUQUE FAMILY EYE CARE PC 3343 CENTER GROVE DR STE D DUBUQUE IA 52003 563 588 2093 WOLFE CLINIC 804 S KENYON RD STE 100 FORT DODGE IA 50501 515 576 7777 RIVER CITIES OPHTHALMOLOGY 5409 AVE O STE 118 FORT MADISON IA 52627 319 372 9292 FAMILY EYE CARE 45 STATE ST GARNER IA 50438 641 923 3737 HARLAN VISION CLINIC 2306 12TH ST HARLAN IA 51537 712 755 3893 WOLFE CLINIC 1195 BOYSON RD HIAWATHA IA 52222 319 362 8032 MARK ZIMMER OD (b) (6) INDEPENDENCE IA 50644 319 334 3631 EYE PHYSICIANS AND SURGEONS 2629 NORTHGATE DR IOWA CITY IA 52245 319 338 3623 UIH OPHTHALMOLOGY DEPARTMENT 200 HAWKINS RD IOWA CITY IA 52242 319 356 1616 AMERICAN EYECARE CENTER 2025 MAIN ST KEOKUK IA 52632 319 524 2020 LEMARS OPTOMETRIC CLINIC 120 1ST ST NW LEMARS IA 51031 712 546 4183 EYECARE ASSOCIATES 501 E MAIN ST MARSHALLTOWN IA 50158 641 752 1511 WOLFE CLINIC - MARSHALLTOWN 309 E CHURCH ST MARSHALLTOWN IA 50158 800 542 7956 NORTH IOWA EYE CLINIC 3121 4TH ST SW MASON CITY IA 50402 641 423 8861 VISION CENTER 1700 PARK AVE MUSCATINE IA 52761 563 263 2020 MARK ZIMMER OD (b) (6) OELWEIN IA 50662 319 283 3155 MIDWEST EYE CARE 4353 DODGE ST OMAHA NE 68131 402 552 2020 FIRST EYE ASSOCIATES 8111 DODGE ST STE 143 OMAHA NE 68114 402 354 8111 VISION CARE CLINIC 721 10TH ST ONAWA IA 51040 712 423 2737 WOLFE EYE CLINIC - OTTUMWA 1005 PENNSYLVANIA AVE STE 110 OTTUMWA IA 52501 641 682 8571 MICHAEL PORTZ OD (b) (6) RED OAK IA 51566 712 623 5551 SPRONK VANDER GRIEND & RADKE 928 3RD AVE SHELDON IA 51201 712 324 2552 JAMES CLOEPFIL OD (b) (6) SHENANDOAH IA 51601 712 246 5098 WADZINSKI EYE CLINIC 5855 SUNNYBROOK DR SIOUX CITY IA 51104 712 226 3937 DR KINCAID FETT AND THARP 1000 W 29TH ST STE 302 SOUTH SIOUX CITY NE 68776 402 494 5533 EYECARE CENTRE 2312 23RD ST SPIRIT LAKE IA 51360 712 336 1960 VISION CARE ASSOCIATES 600 ONTARIO ST STORM LAKE IA 50588 712 732 3233 ADVANCED EYE CARE ASSOCIATES 1113 W 3RD ST VINTON IA 52349 319 472 3848 CEDAR VALLEY EYE CARE 909 E SAN MARNAN DR WATERLOO IA 50702 319 234 2616 MAUER EYE CENTER 2515 CYCLONE DR WATERLOO IA 50701 319 433 3000 WOLFE CLINIC 999 HOME PLZ WATERLOO IA 50701 319 287 5890 RIVER CITIES OPHTHALMOLOGY 1223 S GEAR AVE STE 307 WEST BURLINGTON IA 52655 319 752 2020 DES MOINES EYE SURGEONS 5901 WESTOWN PKWY STE 200 WEST DES MOINES IA 50266 515 225 3546 PHYSICIANS EYE CLINIC 2101 WESTOWN PKWY WEST DES MOINES IA 50265 515 225 2566 WOLFE CLINIC 6200 WESTOWN PKWY WEST DES MOINES IA 50266 515 223 8685

X-RAYS NAME ADDR1 CITY ST ZIP AREA EX NUMB MONROE COUNTY HOSPITAL 6580 165TH ST ALBIA IA 52531 641 932 2134 KOSSUTH REGIONAL HEALTH CENTER/CLINIC 1515 S PHILLIPS ST ALGONA IA 50511 515 295 7714 CASS COUNTY MEMORIAL HOSPITAL 1501 E 10TH ST ATLANTIC IA 50022 712 243 7590 AUDUBON COUNTY MEMORIAL HOSPITAL 515 PACIFIC AVE AUDUBON IA 50025 712 563 2611 DAVIS COUNTY HOSPITAL - X-RAY 509 N MADISON ST BLOOMFIELD IA 52537 641 664 2145 BROOKLYN MEDICAL CLINIC 128 JACKSON ST BROOKLYN IA 52211 641 522 7221 ST ANTHONY REGIONAL HOSPITAL 311 S CLARK ST CARROLL IA 51401 712 792 3581 SARTORI MEMORIAL HOSPITAL 515 COLLEGE ST CEDAR FALLS IA 50613 319 268 3000 RADIOLOGY CONSULTANTS OF IOWA 1948 1ST AVE NE CEDAR RAPIDS IA 52402 319 832 1742 MERCY MEDICAL CTR - RADIOLOGY 701 10TH ST SE CEDAR RAPIDS IA 52403 319 861 7778 RADIOLOGY CONSULTANTS OF IOWA 1948 1ST AVE NE CEDAR RAPIDS IA 52402 319 364 121 ST LUKES HOSPITAL 1026 A AVE NE CEDAR RAPIDS IA 52406 319 369 7211 MERCY MEDICAL CENTER 1 SAINT JOSEPH DR CENTERVILLE IA 52544 641 437 4111 LUCAS COUNTY HEALTH CENTER 1200 N 7TH ST CHARITON IA 50049 641 774 3000 VAL O LYONS MD (b) (6) CHARLES CITY IA 50616 641 257 4309 FLOYD COUNTY MEMORIAL HOSPITAL 800 11TH ST CHARLES CITY IA 50616 641 257 4301 CHEROKEE REGIONAL MEDICAL CENTER 300 SIOUX VALLEY DR CHEROKEE IA 51012 712 225 5101 CLARINDA REGIONAL HEALTH CENTER 17TH & WELLS ST CLARINDA IA 51632 712 542 2176 MERCY MEDICAL CENTER - NORTH CAMPUS 1410 N 4TH ST CLINTON IA 52732 563 244 5642 CHEST INFECTIOUS DISEASE & CRITICAL CARE ASSOC 1601 NW 114TH ST STE 347 CLIVE IA 50325 515 224 1777 CORRIDOR RADIOLOGY 2769 HEARTLAND DR STE 105 CORALVILLE IA 52241 319 545 7300 ALEGENT HEALTH MERCY HOSPITAL 603 ROSARY DR CORNING IA 50841 641 322 3121 WAYNE COUNTY HOSPITAL 417 S EAST ST CORYDON IA 50060 641 872 2260 JENNIE EDMUNDSON MEMORIAL HOSPITAL 933 E PIERCE ST COUNCIL BLUFFS IA 51503 712 396 7600 MILLER ORTHOPAEDIC AFFILIATES ONE EDMUNDSON PLACE STE 500 COUNCIL BLUFFS IA 51503 712 323 5333 CONSULTANTS IN DISABILITY 427 E KANESVILLE STE 407 COUNCIL BLUFFS IA 51503 402 317 2480 REGIONAL HEALTH SYSTEM 235 8TH AVE W CRESCO IA 52136 563 547 2101 GENESIS HEALTH GROUP 1520 W 53RD STE 1 DAVENPORT IA 52806 563 421 4900 GENESIS MEDICAL CENTER 1401 W CENTRAL PARK AVE DAVENPORT IA 52804 563 421 3200 WINNESHIEK MEDICAL CENTER 901 MONTGOMERY ST DECORAH IA 52101 563 382 2911 GUNDERSEN CLINIC LTD 1830 STATE HWY 9 DECORAH IA 52101 563 382 3140 CRAWFORD COUNTY MEMORIAL HOSPITAL 100 MEDICAL PKWY DENISON IA 51442 712 265 2651 THE IOWA CLINIC RADIOLOGY 1221 PLEASANT ST DES MOINES IA 50309 515 244 5109 MERCY MEDICAL CENTER - RADIOLOGY DEPT 1111 6TH AVE DES MOINES IA 50314 515 247 3130 FINLEY HOSPITAL (RADIOLOGY) 350 N GRANDVIEW AVE DUBUQUE IA 52001 563 557 2787 CENTRAL COMMUNITY HOSPITAL 901 DAVIDSON ST NW ELKADER IA 52043 563 245 7000 PALO ALTO COUNTY HOSPITAL 3201 1ST ST EMMETSBURG IA 50536 712 852 5500 THE FAIRFIELD CLINIC 2000C S MAIN ST FAIRFIELD IA 52556 641 472 4141 MERCY FAMILY CLINIC - FOREST CITY 635 E US HIGHWAY 9 FOREST CITY IA 50436 641 585 2904 UNITYPOINT TRINITY REGIONAL MEDICAL CENTER 802 KENYON RD FORT DODGE IA 50501 515 574 6528 FORT MADISON COMMUNITY HOSPITAL 5445 AVE O FORT MADISON IA 52627 319 372 6530 GUTHRIE COUNTY HOSPITAL 710 N 12TH ST GUTHRIE CENTER IA 50115 641 332 2201 MYRTUE MEMORIAL HOSPITAL 1213 GARFIELD AVE HARLAN IA 51537 712 755 5161 COMMUNITY HOSPITAL 1111 11TH ST HAWARDEN IA 51023 712 551 3100 MERCY CARE BLAIRS FERRY 1790 BLAIRS FERRY RD HIAWATHA IA 52233 319 294 5080 HORN MEMORIAL HOSPITAL 701 E 2ND ST IDA GROVE IA 51445 712 364 3311 MERCY HOSPITAL - IOWA CITY 500 E MARKET ST IOWA CITY IA 52245 319 339 300 HANSON FAMILY HOSPITAL 920 S OAK ST IOWA FALLS IA 50126 641 648 7025 GREENE COUNTY MEDICAL CENTER 1000 W LINCOLNWAY JEFFERSON IA 50129 515 386 2114 KEOKUK AREA HOSPITAL 1600 MORGAN ST KEOKUK IA 52632 319 526 8700 KNOXVILLE AREA COMMUNITY HOSPITAL 1002 S LINCOLN KNOXVILLE IA 50138 641 842 2151 STEWART MEMORIAL COMMUNITY HOSPITAL 1301 W MAIN ST LAKE CITY IA 51449 712 464 3171 FLOYD VALLEY HOSPITAL 714 LINCOLN ST NE LEMARS IA 51031 712 546 3394 DECATUR COUNTY HOSPITAL 1405 NW CHURCH ST LEON IA 50144 641 446 4871 REGIONAL MEDICAL CENTER 709 W MAIN ST MANCHESTER IA 52057 563 927 7338 BURGESS FAMILY CLINIC- MAPLE VALLEY 111 S 5TH ST MAPLETON IA 51034 712 882 2234 JACKSON COUNTY PUBLIC HOSPITAL 700 W GROVE ST MAQUOKETA IA 52060 563 652 2474 MARSHALLTOWN MEDICAL & SURGICAL CENTER 3 S 4TH AVE MARSHALLTOWN IA 50158 641 754 5076 MARSHALLTOWN ORTHOPEDICS 312 E MAIN ST STE 2400 MARSHALLTOWN IA 50158 641 752 7191 RADIOLOGISTS OF NORTH IOWA 1010 4TH ST SW STE 100 MASON CITY IA 50401 641 428 5155 MERCY MEDICAL CENTER - NORTH IOWA 1000 4TH ST SW MASON CITY IA 50401 641 428 7000 MERCYCARE MONTICELLO 619 S MAIN ST MONTICELLO IA 52310 319 465 5937 RINGGOLD COUNTY HOSPITAL 504 N CLEVELAND ST MOUNT AYR IA 50854 641 464 3226 HENRY COUNTY HEALTH CENTER 407 S WHITE ST MOUNT PLEASANT IA 52641 319 385 3141 UNITYPOINT TRINITY HOSPITAL MUSCATINE 1518 MULBERRY AVE MUSCATINE IA 52761 563 264 9100 MCFARLAND CLINIC - NEVADA 230 6TH ST NEVADA IA 50201 515 382 5471 SKIFF MEDICAL CENTER 204 N 4TH AVE E NEWTON IA 50208 641 791 4310 MERCY HOSPITAL OF FRANCISCAN SISTERS 201 8TH AVE SE OELWEIN IA 50662 319 283 6000 MIDTOWN MEDICAL GROUP 101 N 38TH AVE OMAHA NE 68131 402 558 1440 BURGESS HEALTH CENTER 1600 DIAMOND ST ONAWA IA 51040 712 423 2311 CLARKE COUNTY HOSPITAL 800 S FILLMORE ST OSCEOLA IA 50213 641 342 2184 MAHASKA HEALTH PARTNERSHIP 410 N 12TH ST OSKALOOSA IA 52577 641 672 2090 MAHASKA COUNTY HOSPITAL 1229 C AVE E OSKALOOSA IA 52577 641 673 3431 RADIOLOGY ASSOCIATES OF OTTUMWA 1005 PENNSYLVANIA AVE STE 103 OTTUMWA IA 52501 641 682 5453 PELLA REGIONAL HEALTH CENTER 404 JEFFERSON ST PELLA IA 50219 641 628 3150 HEGG MEMORIAL HEALTH CENTER 1202 21ST AVE ROCK VALLEY IA 51247 712 476 8000 LORING HOSPITAL 211 HIGHLAND AVE SAC CITY IA 50583 712 662 7105 SHENANDOAH MEDICAL CENTER 300 PERSHING AVE SHENANDOAH IA 51601 712 246 1230 SIOUX CENTER COMMUNITY HOSPITAL 1101 9TH ST SE SIOUX CENTER IA 51250 712 722 1271 ST LUKES REGIONAL MEDICAL CENTER 2720 STONE PARK BLVD SIOUX CITY IA 51104 712 279 7979 MERCY MEDICAL CENTER - SCHEDULING 801 5TH ST SIOUX CITY IA 51101 800 284 7231 CARDIOVASCULAR ASSOCIATES 2720 STONE PARK BLVD STE 110 SIOUX CITY IA 51104 712 239 4702 DOUGLAS MARTIN MD (b) (6) SIOUX CITY IA 51109 712 224 4300 PRAIRIE PEDIATRIC & ADOLESCENT CLINIC 1125 PIERCE ST SIOUX CITY IA 51105 712 255 8901 CENTER FOR FAMILY MEDICINE 1115 E 20TH ST SIOUX FALLS SD 57105 605 575 1633 MIDTOWN MEDICAL GROUP 3900 DAKOTA AVE STE 5 SOUTH SIOUX CITY NE 68776 402 558 1440 AVERA SPENCER FAMILY CLINIC 116 E 11TH ST STE 101 SPENCER IA 51301 712 264 3530 SPENCER MUNICIPAL HOSPITAL 1200 1ST AVE E SPENCER IA 51301 712 264 6181 LAKES REGIONAL HEALTH CARE 2301 HIGHWAY 71 SPIRIT LAKE IA 51360 712 336 1230 BUENA VISTA REGIONAL MEDICAL CENTER 1525 W 5TH ST STORM LAKE IA 50588 712 732 4030 UNITYPOINT BUENA VISTA CLINIC 620 NORTHWESTERN DR STORM LAKE IA 50588 712 732 5030 VIRGINIA GAY HOSPITAL 502 N 9TH AVE VINTON IA 52349 319 472 6200 COVENANT MEDICAL CENTER 3421 W 9TH ST WATERLOO IA 50702 319 272 8000 ALLEN MEMORIAL HOSPITAL 1825 LOGAN AVE WATERLOO IA 50702 319 235 5100 NORTHEAST IOWA FAMILY PRACTICE CENTER 2055 KIMBALL AVE WATERLOO IA 50702 319 272 2112 VETERANS MEMORIAL HOSPITAL 40 1ST ST SE WAUKON IA 52172 563 568 3411 VAN DIEST MEDICAL CENTER 2350 HOSPITAL DR WEBSTER CITY IA 50595 515 832 7739 GREAT RIVER MED CTR SCHEDULING 1221 S GEAR AVE WEST BURLINGTON IA 52655 319 768 3590 BARAZANJI FAMILY MEDICAL CLINIC 1701 22ND ST WEST DES MOINES IA 50266 515 440 6622 BASIL HASSAN MD 230 S 68TH ST STE 1203 WEST DES MOINES IA 50266 515 471 1800 MADISON COUNTY MEDICAL ASSOCIATES 60 E COURT AVE WINTERSET IA 50273 515 462 1162

KEY VOLUME VENDORS IN IOWA – May 2016 - MAY 2017

Rank for Name Amount Paid 1 Carroll Roland, PHD $ 248,209 2 Wahl Psychological Services $ 129,600 3 Rich Martin, PHD $ 122,500 4 Roger Mraz, PHD $ 116,472 5 Medix Occupational Medicine $ 79,750 6 Rosanna Jones Thurman PHD $ 70,750 7 Midtown Medical $ 68,352 8 Psychology Health Group $ 60,100 9 Plains Area MHC $ 56,225 10 Basil Hassan MD $ 52,246 Total paid out this period $ 1,004,424 Total paid out last period $ 940,026

The following vendors were not reviewed this year: Carroll Roland PHD, Roger Mraz, PHD and Psychology Health Group as they were all reviewed in 2016. Tim Wahl PHD, Rich Martin PHD, and John Kuhnlein DO, as they were all reviewed in 2015.

The following vendors received an onsite visit this year; Rosanna Jones Thurman, PHD, Midtown Medical Group, Plains Area MHC and Basil Hassan MD are all in the top ten and have not been reviewed in several years. Russell Moulton also received an onsite visit, as he has consistently ranked in the top 20, but has never received a review.

11/03/2017 KANSAS TOP CE VENDORS 10/1/2016 THRU 9/30/2017 KEY OR VOLUME VENDNAME AMT PAID KEY/VOLUME PROVIDER-Primary STANLEY I MINTZ PH D $203,597.64 KEY/VOLUME PROVIDER-Primary CENTRAL MEDICAL CONSULTANTS $164,877.02 KEY PROVIDER-Primary MICHAEL H SCHWARTZ PHD $135,893.70 KEY PROVIDER-Primary SOUTHERN MEDICAL GROUP INC $97,465.12 KEY PROVIDER-Primary STEVEN WALTERS LCP $76,046.62 KEY PROVIDER-Primary JASON E. NEUFELD, PH.D. $74,313.00 KEY PROVIDER-Primary JARROD S STEFFAN PH D $74,263.00 KEY PROVIDER-Primary MIDWEST CES $69,838.39 KEY PROVIDER-Primary MELVIN R BERG PH D $59,639.00 JAN SNIDER KENT PHD $45,430.71 KOENEMAN PSYCHOLOGICAL SERVICES LLC $44,955.00 KEY PROVIDER-Primary REDLINK $35,061.96 GARY R HACKNEY PHD $33,480.00 THOMAS S BARTLETT PSYD $30,010.00 KEY PROVIDER-Primary EVE MEDICAL SERVICES LLC $22,710.82 JOI MCNELEY-PHELPS, PH.D. $20,570.94 TODD A SCHEMMEL PH D $18,880.00 DAVID PULCHER PHD $18,830.00 TAMMY E SHEEHAN PSYD $18,351.95 KAREN M JORDAN PH D $17,704.94 RICK THOMAS PHD $13,714.34 PRISCILLA WALLINGFORD PH D $13,459.00 GEORGETTE YETTER PHD $12,568.00 CAROLYN KARR PHD $11,857.39 JASON R WELLS PSY D $11,635.00 MELINDA SHAVER PSY D $11,619.00 T A MOELLER PH D $11,279.00 NEW - ADDED EMILY RUNYAN LCP $10,940.00 NEW - ADDED COMMUNITY HEALTH CTR OF SE KANSAS $10,822.00 BRUCE W BEAN PHD $10,454.00 NEW - ADDED MARC QUILLEN PHD $10,132.00 CYNTHIA WILSON PSYD $10,040.00 ST JOSEPH MEDICAL CENTER $9,222.66 REMOVED SAAD M. AL-SHATHIR, M.D. $8,914.14 REMOVED (b) (6) DENNIS HEMMENDINGER PHD $8,142.00 DOMINICK SCALISE PHD LLC $7,271.00 JACKIE TENNEY MD $6,507.20 DIVINA VERNER MD $6,284.52 NEW - ADDED SERENITY PSYCHOLOGICAL SERVICES $5,975.00 PROVIDENCE MEDICAL CENTER $5,922.70 UNIVERSITY OF KANSAS HOSPITAL $5,662.33 ERICA SMITH SLP $5,239.20 STORMONT-VAIL HEALTHCARE $4,588.72 HUTCHINSON REGIONAL MEDICAL CENTER $4,423.37 WICHITA FAMILY VISION CLINIC $4,384.31 NEW - ADDED RENEW EATING DISORDER RECOVERY $4,080.00 SAM N COHLMIA MD $3,749.41 MANISH DIXIT, M.D. $3,688.74 KANSAS IMAGING CONSULTANTS PA $3,655.12 RANDALL J KRESIE MD $3,623.76 TERRY B ROTHSTEIN MD $3,604.34 (b) (6) REMOVED ALY A GADALLA MD $3,197.26 SITHA U MILLER MD $3,005.64 JENNIFER A MADER CCC-SLP $2,841.60 HEATHER R ESTRADA SLP $2,841.60 LABETTE HEALTH $2,798.06 UNITED IMAGING CONSULTANTS $2,743.65 VIA CHRISTI HOSPITAL PITTSBURG INC $2,724.90 OLATHE MEDICAL CENTER $2,721.84 LAWRENCE MEMORIAL HOSPITAL $2,677.34 NEW - ADDED BILINGUAL SPEECH THERAPY OF KANSAS $2,663.20 CINDY E. PENZLER, MD $2,564.21 ERIC FRY, MD $2,464.47 RANDALL A POHLENZ OD $2,256.28 11/03/2017 KANSAS TOP CE VENDORS 10/1/2016 THRU 9/30/2017 COFFEYVILLE REGIONAL MEDICAL CENTER $2,170.59 RADIOLOGY & NUCLEAR MEDICINE $2,146.80 EYECARE ASSOCIATES OF OSAWATOMIE $2,085.79 VIA CHRISTI HOSPITAL MANHATTAN $2,032.82 WESTERN PLAINS MEDICAL COMPLEX $2,029.87 ST ROSE HEALTH CARE $1,954.70 SOUTHWEST MEDICAL CENTER $1,833.09 SHEILA WOOD CCC-SLP $1,776.00 GEARY COMMUNITY HOSPITAL $1,711.31 SHELLY BREDIN-OJA, SPEECH THERAPIST $1,598.40 HAYS AREA CHILDREN'S CENTER $1,598.40 MEMORIAL HOSPITAL, INC. $1,583.59 RANSOM MEMORIAL HOSPITAL $1,562.09 HAYS MEDICAL CENTER-ST ANTHONY CAMPUS $1,510.31 REMOVED (b) (6) JOYCE A WOODFORD PHD $1,440.00 PRATT REGIONAL MEDICAL CENTER $1,422.12 HOLLY MCCARTER MA CCC-SLP-L $1,420.80 SUSAN B ALLEN MEMORIAL HOSPITAL $1,406.35 AUDIOLOGY & HEARING AID SERVICES INC $1,363.10 ST CATHERINE HOSPITAL $1,293.90 REMOVED (b) (6) AVNER STERN PHD $1,270.00 PRAIRIE WIND EYECARE $1,238.31 LYLE SMITH MD $1,229.58 NEOSHO MEMORIAL HOSPITAL $1,162.80 FREEMAN WEST HOSPITAL $1,119.06 MOLLY E. CHASE SLP $1,065.60 RADIOLOGY PROF OF HUTCHINSON LLC $927.96 WAYNE L ANLIKER MD $905.23 JOHN J SAND MD $865.48 DONALD L JAMES MD $819.72 ALLEN COUNTY HOSPITAL $808.00 NEWMAN MEMORIAL COUNTY HOSPITAL $737.79 UNITED RADIOLOGY BILLING LLC $730.80 MERCY HOSPITAL $719.85 GREAT PLAINS RADIOLOGY SERVICES $717.00 NEWTON MEDICAL CENTER $714.21 NEW - ADDED MICHAEL J JOHNSON MD $683.10 ATCHISON HOSPITAL $673.46 COMMUNITY MEMORIAL HOSPITAL $666.02 WILLIAM NEWTON MEMORIAL HOSPITAL $627.63 RADIOLOGY ASSOCIATES OF HAYS PA $619.19 MANHATTAN RADIOLOGY $589.15 RADIOLOGY IMAGING ASSOCIATES PC $565.01 PROFESSIONAL HEARING AID ASSOCIATES $532.24 ONE TIME PCP EXAM LINDA SCHULTZ MS $510.92 KU MEDWEST $472.09 AREA HEARING & SPEECH CLINIC $460.17 STEVE C MITCHELL SR OD $457.51 MEREDITH POORE HAROLD PHD CCC-SLP $444.00 MEMORIAL HOSPITAL $430.85 FREEMAN PHYSICIAN GROUP $425.61 RADIOLOGIC PROFESSIONAL SERVICES PA $418.92 SUMNER REGIONAL MEDICAL CENTER $414.88 MIAMI COUNTY MEDICAL CENTER, INC. $405.52 DONALD C WHITE MD PA $398.87 KIM HENDRICKS M A CCC-A $397.70 CLOUD COUNTY HEALTH CENTER $394.15 PHILLIPS COUNTY HOSPITAL $361.04 ST JOHN HOSPITAL $344.30 ROBERT CHARLES GIBBS MD $318.17 CHANUTE RADIOLOGY, P.A. $312.01 NEW - ADDED DAVID LINSENMEYER $310.00 SELECT SPECIALTY HOSPITAL WICHITA $287.40 CITIZENS MEDICAL CENTER $287.30 SOUTH CENTRAL REGIONAL MEDICAL CENTER $273.69 11/03/2017 KANSAS TOP CE VENDORS 10/1/2016 THRU 9/30/2017 KINGMAN COMMUNITY HOSPITAL $256.55 VIA CHRISTI CLINICS CENTRALIZED $217.44 GOODLAND REGIONAL MEDICAL CENTER $200.21 HIAWATHA COMMUNITY HOSPITAL $199.92 NEW - ADDED RADIOLOGY SPECIALISTS OF ST. JO $192.32 MORTON COUNTY HOSPITAL $177.15 MARSTON HEARING CENTER $168.33 NEW - ADDED PRECISION RADIOLOGY LLC $163.58 ELLSWORTH COUNTY MEDICAL CENTER $155.40 A ZAINALI MD $147.96 MELISSA M. MALONE, M.D. $140.40 R J KUEKER MD $137.19 ONE TIME PCP EXAM MAHESH MOHAN MD $136.62 ONE TIME PCP EXAM BARBARA A BROWN-APPLEGATE DO $125.00 NEW - ADDED STEVENS COUNTY HOSPITAL $114.05 HORTON COMMUNITY HOSPITAL $112.97 HOXIE MEDICAL CLINIC $102.00 KEVIN L HAMM DO $100.27 KEVIN S HUGHES DO $99.19 KRISHNA M KOTECHA MD $95.56 WICHITA RADIOLOGICAL GROUP PA $83.54 ROBERT LACKAMP MD PC $40.50 FORT HAYS STATE UNIVERSITY $39.77 DIVERSIFIED RADIOLOGY OF COLORADO $37.12 RADIOLOGY SERVICES PC $21.00 COMMUNITY HOSPITAL $16.39 E CLOUD RADIOLOGY LLC $8.16 KENTUCKY DDS FY 2017 CE PROVIDERS LIST Paid Amount PAYTAXID PAYVENDCD PAYNAME $8,190.00 ELIZABETH I CARLETON-SCHEPER SLP $205.00 MALINDA ISAACS PHD $8,810.00 (b) (6) LESLIE JENKINS PHD $11,115.00 KEN EPPERSON MS-LPP $4,800.00 GAIL WALSH MS CCC SLP $47,060.00 RUTH BEWLEY, PHD $5,370.00 MEDICAL VISION INSTITUTE $100,810.00 LISA KING PSYD $6,910.00 WILLIAM M. PARELL, MD.,PSC. $2,229.00 JAN J. WEISBERG, MD. $3,490.00 EYE CARE FOR KENTUCKY $4,514.00 BOURBON PHYSICIAN PRACTICE $28,575.00 LITTLE PSYCHOLOGICAL SERVICES $40,930.00 ROBERT GENTHNER PHD $35,995.00 ROBERT W ADAMS PSYD $11,575.00 MARC PLAVIN PHD $680.00 COMMONWEALTH SPECIALISTS OF KY $3,600.00 MARK S PARZYCH MA-LPP $20,422.00 STEVEN J SIMON PHD $7,175.00 RAFAEL VEROSLAVSKY PSYD $1,560.00 JASON MCCLOUD OD $440.00 CENTRAL KENTUCKY INTERPRETER REFERRAL INC $23,160.00 GERALDO DA COSTA LIMA PHD $69,702.00 RIVER CITY HEALTH SERVICES $190.00 ENT SPECIALISTS OF NASHVILLE $750.00 JARVIS VISION CENTER, PLLC $9,320.00 ELLEN YASS-REED MA PLLC $22,700.00 BARBARA M BAKER & ASSOCIATES LLC $47,145.00 BRENDAN RYAN MS-LPP $30,870.00 M MAUDE O'NEILL PHD LLC $126,650.00 DANIEL A MILLER PHD $125,400.00 TIMOTHY L BAGGS PSYD $9,411.00 ADVANCED EAR NOSE THROAT & ALLERGY PLLC $84,630.00 MEGAN L GREEN PSYD $21,785.00 COMPREHENSIVE NEUROPSYCHOLOGICAL ASSESSMENT $43,470.00 GARY STEWART PHD PSC $2,250.00 DENNIS J BUCHHOLZ PHD $23,520.00 RICHARD L KLEM PHD $66,035.00 JENNIFER L FISHKOFF PSYD $210.20 HEARING SPEECH AND DEAF CENTER $870.00 TRI-STATE CENTERS FOR SIGHT $3,705.00 EYE CARE ASSOCIATES OF GREATER CINCINNATI $17,335.00 PSYCHOLOGICAL CONSULTS $220.00 MARVA P JOHNSON $20,605.00 JEFFREY W GRAY PHD $2,910.00 ASSOCIATES IN EYE CARE $4,125.00 TIM J CONRAD MD $412,807.00 LIBERTY MEDICAL ASSESSMENT LLC $4,695.00 BENJAMIN MACKEY MD $71,140.00 WILLIAM R RIGBY PHD $22,060.00 (b) (6) BARRY ADKINS MS $57,030.00 SOMERSET SPEECH/LANGUAGE PATHOLOGY $6,100.00 BRITTANY ONKST SLP $16,745.00 MARY ALLEN GENTHNER MS $1,002.00 EDITH DOT STALLARD $38,140.00 MARK KROGER MS $16,305.00 WAYNE HERNER PSYD $17,760.00 R COURTNEY SPEAR MA $1,680.00 DAVID ATCHER MD $76,235.00 CRISTI HUNDLEY PHD $4,500.00 CHARLENE C SHEEHAN SLP $347,787.75 WELLCARE INC $135,940.00 GREGORY LYNCH PHD $3,205.00 PAUL A. OWEN $55,530.00 J LORILEA CONYER MA, LPP $150.00 MY LE K. NGUYEN $50,825.00 GEOFF SCHWERZLER PSYD $121,230.00 FORD MENTAL HEALTH SERVICES $11,190.00 JULIE JOSEPH-FOX $37,735.00 MICHAEL E. WHITTEN PHD $297,706.00 SKAGGS CONSULTING, PLLC $77,815.00 BRIAN E. MCLEAN MS-LPP $91,300.00 AAFREEL, LLC $7,800.00 WIGHT SPEECH AND LANGUAGE SERVICES LLC $102,170.00 SHAW PSYCHOLOGICAL SERVICES LLC $34,075.00 JODI BAUER, LLC $4,530.00 DR EDD EASTON-HOGG PSYD LLC $25,740.00 SOUND PATH LLC $60,075.00 THE SCOTT GROUP, PLLC $36,580.00 CAPSTONE PSYCHOLOGICAL SERVICES PLLC $275.00 INTERPRETING SERVICE OF THE COMMONWEALTH, LLC $71,031.00 WALPERT PSYCHOLOGICAL & CONSULTING SERVICES PLLC $25,050.00 LIME KILN CONSULTING LLC $19,595.00 KERRICK PSYCHOLOGICAL SERVICES $39,515.00 SOUTHLAND COUNSELING AND ASSESSMENT CENTER $1,156.50 RICHARD E PURNELL $27,955.00 JONES PSYCHOLOGICAL SERVICE LLC $1,700.00 DAVID L WINSCH PHD $80.00 MIDDLESBORO ARH $6,381.00 JOSEPH TOUMA M.D. $225,535.62 TRI-STATE OCCUP MED INC $19,850.00 MIDLANDS BEHAVIORAL MEDICINE INC $19,025.00 HORN AND ASSOCIATES IN REHABILITATION $916.30 HARRISON MEMORIAL HOSPITAL $1,444.60 CALDWELL MEDICAL CENTER $517.60 COALMINER RESPIRATORY CLINIC $3,069.00 PIKEVILLE MEDICAL CENTER $1,415.20 ROCKCASTLE HOSPITAL INC $8,536.65 BAPTIST HEALTH MADISONVILLE $90.00 KENTUCKY HEART & VASCULAR PHYSICIANS $7,025.00 (b) (6) NORTHKEY COMMUNITY CARE $875.65 GRAVES GILBERT CLINIC $966.95 NORTON HEALTHCARE $2,565.00 THE OPHTHALMOLOGY GROUP LLP $1,635.00 KOBY & KARP PSC $3,315.00 ENT AND ALLERGY SPECIALISTS $450.00 ASHLAND PEDIATRIC ASSOCIATES P $667.00 ROBERT WOODS II MD $477,900.50 STORY CONSULTING SERVICES INC $1,965.00 MAURICE J OAKLEY MD $270.00 WEST KENTUCKY REFUGEE MUTUAL A $2,480.00 PIKEVILLE RADIOLOGY $8,300.00 S H K REDDY MD $30,135.25 JAMES C OWEN MD $6,435.00 THEODORE WANDZILAK MD $3,940.90 AABDUL DAHHAN MD PSC $53,655.00 DENNIS B SPRAGUE PHD PSC $1,890.00 EYE INSTITUTE OF CENTRAL KENTU $2,085.00 ANTHONY MAYO OD $7,060.00 JAMES W MATTHEWS MD PSC $75.00 JOSEPH R BRIGHTWELL MD $3,045.00 EDMUND WILKINS MD $2,295.00 CATHOLIC CHARITIES INC $338.00 EYECARE SPECIALISTS $16,335.00 MICHELE AMBURGEY MA $123,575.00 DENNIS PSYCHOLOGICAL SERVICES $1,365.00 MCPEAK VISION PARTNERS $55,915.00 ONSITE MEDICAL SERVICES $29,335.00 EAST KY THERAPY CLINIC $830.00 MEDICAL CENTER CARDIOLOGISTS $21,540.00 DISABILITY CONSULTANTS OF KENTUCKY LLC $1,900.00 EMILY G LAIRD CCC,SLP MA $3,600.00 PEDIATRIC HEALTH GROUP $947.40 W LAWRENCE LONG MD PLLC $38,536.00 SAHNER & ASSOCIATES INC $5,106.00 LAKE CUMBERLAND MEDICAL ASSOCIATES $129,208.00 SOUTHERN MEDICAL GROUP INC $9,565.00 REYNOLDS-BLACKBURN PSYCHOLOGICAL SERVICE $31,020.00 G STEPHEN PERRY EDD $11,455.00 DENNIS BUCHHOLZ, PH.D. $16,415.00 LESLIE JENKINS PHD $9,150.00 KATHY SEIGLER, SEIGLER PSYCHOLOGICAL SERVICES $770.00 KERI BARLOW MS CCC SLP $200.00 NU CARE $5,177.00 ACCIPIO LANGUAGES SERVICES Louisiana FY 2017

VENDCD VENDOFF VENDNAME ADDR1 ADDR2 ADDR3 CITY STATE ZIP (b) (6)J PAUL SWEARINGEN MD 7607 YOUREE DR PIERREMONT EYE INSTITUTE SHREVEPORT LA 71105 ROBERT T CASANOVA JR MD 1110 DR AC TERRENCE BLVD SUITE 1 OPELOUSAS LA 70570

LYNDE ULMER LCSW 7737 OLD HAMMOND HWY #A3 BATON ROUGE LA 70809

EMMETT B CHAPITAL JR M D (b) (6) NEW ORLEANS LA 70119

THOMAS E STAATS PH D 2924 KNIGHT ST BLDG 3, SUITE 357 SHREVEPORT LA 71105

NEW ORLEANS SPEECH AND HEARING CENTER 1636 TOLEDANO NEW ORLEANS LA 70115

NEW ORLEANS SPEECH AND HEARING EAST 5646 READ BLVD SUITE 320 NEW ORLEANS LA 70127

FAYE C THRASHER (b) (6) ALEXANDRIA LA 71301

MED PLUS LA OPELOUSAS 204 N. UNION ST. ORTEGO CHIROPRACTIC CLINIC OPELOUSAS LA 70570

MED PLUS NEW IBERIA 800 WEST MAIN ST BRYANT WELLNESS CLINIC NEW IBERIA LA 70560

MED PLUS LA ALEXANDRIA 2595 NORTH MACARTHUR DRIVE ALEXANDRIA LA 71303

MED PLUS LA BOSSIER CITY 3018 OLD MINDEN RD SUITE 203 BOSSIER CITY LA 71112-2427

MED PLUS LA AMITE STE D MED PLUS AMITE - D. W. RAY, M.D. 309 WALNUT AMITE LA 70422

MED PLUS LAKE CHARLES 1210 EAST MCNEESE ST LAKE CHARLES LA 70607

MED PLUS LA LAF 2201 KALISTE SALOOM SUITE 202 LAFAYETTE LA 70508

MED PLUS LA MONROE CHS-CHIROPRACTIC HEALTH SERVICES, LLC 610 CYPRESS STREET WEST MONROE LA 71291

COVINGTON SPEECH AND LANGUAGE CENTER 424 SOUTH TYLER COVINGTON LA 70433

HUSSEIN ALAMMAR MD (b) (6) LEESVILLE LA 71446

ACADIANA MEDICINE CLINIC SUITE 4 1200 HOSPITAL DRIVE OPELOUSAS LA 70570

SPEECH CONCEPTS LLC SUITE 210 8870 YOUREE DRIVE SHREVEPORT LA 71115

KIM A JOHNSON-LCSW (b) (6) ALEXANDRIA LA 71301

A A FRANCIS MD OPTIMAL HEALTH OUTPATIENT CLIN 7240 RENOIR AVENUE BATON ROUGE LA 70806

D L MOORE PH D 805 STUBBS AVE SUITE B MONROE LA 71201

MICHAEL D MANUEL MD (b) (6) ALEXANDRIA LA 71301

PEDIATRIC GROUP OF ACADIANA SUITE 100 MEDICAL RECORDS 401 YOUNGSVILLE HIGHWAY LAFAYETTE LA 70508

DR. SAI CHENNAMSETTY 401 YOUNGSVILLE HWY STE 200 B LAFAYETTE LA 70508

ACI HEARING AND BALANCE CENTER 103 ST. THOMAS ST. LAFAYETTE LA 70506

PAUL M FRIEDBERG PH D SUITE 304 2020 W. PINHOOK RD. LAFAYETTE LA 70508

NAOMI FRIEDBERG PHD SUITE 304 2020 WEST PINHOOK RD LAFAYETTE LA 70508

VICTOR M OLIVER MD (b) (6) BATON ROUGE LA 70806

GIRISHKUMAR SHAH MD 409 MARINERS PLAZA SUITE A MANDEVILLE LA 70448

SPEECH PATHOLOGY OF LOUISIANA SUITE 401 8676 GOODWOOD BLVD BATON ROUGE LA 70806

DONNELL C ASHFORD 8676 GOODWOOD BOULEVARD SUITE 202 BATON ROUGE LA 70806

AUDIOLOGY ASSOCIATES (DUCOMBS) MEDICAL RECORDS 15706 PROFESSIONAL PLAZA HAMMOND LA 70403

CHRISTINE B POWANDA PHD TERRYTOWN 1799 STUMPF BLVD BLDG 7 SUITE 1A TERRYTOWN LA 70056

CHRISTINE B POWANDA PHD CO NORTHSHORE SOUTHSHORE COUNSELING 201 HOLIDAY BLVD SUITE 120 COVINGTON LA 70433

NICOLE F LANCLOS HOPE MEDICAL SERVICES 5615-D JACKSON ST EXTENSION 2ND BUILDING COURTYARD ALEXANDRIA LA 71303

NICHOLE F. LANCLOS PHD 2020 WEST PINHOOK RD. SUITE 504 LAFAYETTE LA 70508 (b) (6) POINT OF CARE HEALTH HOUMA 210 NEW ORLEANS BLVD HOUMA LA 70364 POINT OF CARE BATON ROUGE 7354 ALBERTA ST SUITE A BATON ROUGE LA 70808

SUNRISE PEDIATRIC ASSOCIATES 3116 SIXTH STREET SUITE 101 METAIRIE LA 70002

ASHLEY W SIPES M D (b) (6) SHREVEPORT LA 71105

CAROLYN FLEMING (b) (6) MONROE LA 71201

JAMES QUILLIN PHD (b) (6) ALEXANDRIA LA 71303

PREMIER HEAR & BAL HAMMOND 16038 DOCTORS BLVD HAMMOND LA 70403

PREMIER HEAR & BAL MANDEVILLE 3545 HIGHWAY 190 MANDEVILLE LA 70471

R ASHTON HOLLOWAY MD (b) (6) BATON ROUGE LA 70806

SOUTHERN MEDICAL GR SHREVEPORT 2924 KNIGHT ST, BLDG 4, SUITE 440 SHREVEPORT LA 71105

SOUTHERN MEDICAL GR PINEVILLE 1319 DONAHUE-FERRY PINEVILLE LA 71360

SOUTHERN MEDICAL GRP MONROE 1212 STUBBS AVE. MONROE LA 71201

SOUTHERN MEDICAL GRP LAKE CHARLES 4100 LOUISIANA AVENUE LAKE CHARLES LA 70607

SOUTHERN MEDICAL GR LAFAYETTE 345 DOUCET RD SUITE 104B LAFAYETTE LA 70503

SOUTHERN MEDICAL GROUP NATCHITOCHES 366 SOUTH DRIVE NATCHITOCHES LA 71457

JOHN H. FAIRBANKS JR. FAIRBANKS ORTHOPEDIC CENTER 107 FRONT ST. STE 2134 VIDALIA LA 71373

JOSEPH A GUILLORY PHD (b) (6) OPELOUSAS LA 70570

INTERNAL MEDICINE ASSOCIATES NEW ORLEANS FIRST FLOOR 618 N CARROLLTON AVE NEW ORLEANS LA 70119

INTERNAL MEDICINE ASSOCIATES KENNER 2001 42ND ST SUITE A KENNER LA 70065

INTERNAL MEDICINE ASSOCIATES TERRYTOWN 1799 STUMPF BLVD. BLDG 5 SUITE 2 TERRYTOWN LA 70056

C SCOTT ECKHOLDT PHD (b) (6) LAFAYETTE LA 70508

SAMUEL WEBB SENTELL PH D (b) (6) SHREVEPORT LA 71106

DR SETH KUNEN 2435 DRUSILLA LANE STE. M BATON ROUGE LA 70809

LA HEART CENTER COVINGTON 39 STARBRUSH CIRCLE COVINGTON LA 70433

LA HEART CENTER HAMMOND 42078 VETERANS AVE SUITE C AND D HAMMOND LA 70403

LA HEART CENTER CHALMETTE 8050 WEST JUDGE PEREZ SUITE 2500 CHALMETTE LA 70043

LA HEART CENTER SLIDELL 2ND FLOOR 901 GAUSE BLVD SLIDELL LA 70458

PERRY HILL, PHD 7330 FERN AVE STE 602 BLDG 6 SHREVEPORT LA 71105

DONALD R PEAVY M D (b) (6) BATON ROUGE LA 70806

THOMAS C STUCKEY III 7777 HENNESSEY BLVD SUITE 3001 BATON ROUGE LA 70808

DANIEL J TRAHANT M D 3901 HOUMA BLVD SUITE 305 METAIRIE LA 70006

TULANE UNIVERSITY HOSPITAL AND CLINIC PULMONARY CLINIC 7TH FLOOR 1415 TULANE AVENUE NEW ORLEANS LA 70112

JACK MILLER JR OD (b) (6) EUNICE LA 70535

GERALD GERDES JR OD (b) (6) OAKDALE LA 71463

DR R V CHRISTIAN (b) (6) OPELOUSAS LA 70570

WILLIAMSON ALLEMOND REGIONAL EYE CENTER 2421 CHURCH ST. ZACHARY LA 70791

CLINICAL PATHOLOGY LABORATORIES 2535 BERT KOUNS INDUSTRIAL LOOP SUITE 219 SHREVEPORT LA 71118

CLINICAL PATHOLOGY LABORATORIES METAIRIE 3901 HOUMA BLVD SUITE 100 METAIRIE LA 70006

CLINICAL PATHOLOGY LABORATORIES- BATON ROUGE 8130 SUMMA AVENUE BATON ROUGE LA 70809 (b) (6) CLINICAL PATHOLOGY LABORATORIES LAKE CHARLES 2800 1ST AVENUE SUITE E LAKE CHARLES LA 70601 CLINICAL PATHOLOGY LABORATORIES ALEXANDRIA 5615-C JACKSON STREET EXTENSION ALEXANDRIA LA 71301

CPL NATCHITOCHES 99 SOUTH DRIVE SUITE A NATCHITOCHES LA 71457

CLINICAL PATHOLOGY LABORATORIES MONROE 221 MCMILLIAN RD SUITE A WEST MONROE LA 71291-5321

CLINICAL PATHOLOGY LABORATORIES NEW ORLEANS 3525 PRYTANIA ST. SUITE 319 NEW ORLEANS LA 70115

CLINICAL PATHOLOGY LABORATORIES HARAHAN 520 ELMWOOD PARK BLVD. SUITE 130 JEFFERSON LA 70123

CLINICAL PATHOLOGY LABORATORIES MARRERO 4520 WICHERS DR. SUITE 102 MARRERO LA 70072

CLINICAL PATHOLOGY LABS- FERN AVE, SHREVEPORT 7607 FERN AVE, SUITE 501 SHREVEPORT LA 71105

CLINICAL PATHOLOGY LABORATORIES HOUMA 900 BELANGER ST. HOUMA LA 70360

CLINICAL PATHOLOGY LABORATORIES HAMMOND 16026 DOCTOR'S BLVD. HAMMOND LA 70403

CLINICAL PATHOLOGY LABORATORIES-COVINGTON 204 HIGHLAND PARK PLAZA COVINGTON LA 70433

CLINICAL PATHOLOGY LABS- BOSSIER CITY 2250 HOSPITAL DRIVE SUITE 112 BOSSIER CITY LA 71111

MICHAEL N KLEAMENAKIS O D (b) (6) NEW ORLEANS LA 70122

MENARD EYE CENTER 4315 LAKE ST SUITE 2 LAKE CHARLES LA 70605

WARREN P MCKENNA JR MD (b) (6) NEW ORLEANS LA 70114

DONNA M MANCUSO MD 1301 ANTONINE STREET SUITE 500 NEW ORLEANS LA 70115

ELENITA P SANTOS-MATA MD 4851 W. PARK SUITE A ZACHARY LA 70791

ANDREW THRASHER PHD 2500 MAPLEWOOD DR SUITE 1 SULPHUR LA 70663

MANUEL DE LA RUA, O.D. 3701 WILLIAMS BLVD SUITE 204 KENNER LA 70065

BRYAN S. JEANFREAU OD 231 WINDERMERE BLVD ALEXANDRIA LA 71303

PATRICK REDMOND MD 231 WINDERMERE BLVD ALEXANDRIA LA 71303

BRYAN S. JEANFREAU OD LOUISIANA EYE LASER CENTER 201 FRITZ STREET JONESVILLE LA 71343

JILL COOK 8762 QUARTERS LAKE BUILDING 12 BATON ROUGE LA 70809

JILL COOK (b) (6) NEW ORLEANS LA 70119

DR STEPHANIE HENSON 1801 FAIRFIELD AVE SUITE 201 SHREVEPORT LA 71101

NATCHITOCHES FAMILY EYE CARE 946 KEYSER AVE NATCHITOCHES LA 71457

DESOTO FAMILY EYE CARE 405 POLK ST MANSFIELD LA 71052

SABINE FAMILY EYE CARE 220B HIGHLAND DR MANY LA 71449

ROBERT L. KRENEK, JR., PHD 3018 OLD. MINDEN RD, SUITE 1100 BOSSIER CITY LA 71112

LINDSAY YORK MD 1111 MEDICAL CENTER BOULEVARD NORTH TOWER ROOM 803 MARRERO LA 70072

ACL HEARING & BALANCE INC 7952 GOODWOOD BLVD BATON ROUGE LA 70806

THE GUIDANCE CENTER - ORLEANS 330 N. JEFFERSON DAVIS PKWY NEW ORLEANS LA 70119

THE GUIDANCE CENTER - CHALMETTE 2626 CHARLES DR SUITE 211 CHALMETTE LA 70043

ELIZABETH B WHITE MD MEDICAL RECORDS SUITE 205 205 HIGHLAND PARK PLAZA COVINGTON LA 70433

JAMES A. VAN HOOK III, PHD 1200 S ACADIAN THRUWAY SUITE 110B BATON ROUGE LA 70806

AMCE PHYSICIANS GROUP-BR 8772 QUARTERS LAKE RD BLDG 13 STE 18 BATON ROUGE LA 70809

AMCE PHYSICIANS GROUP-NEW ORLEANS 1100 POYDRAS STREET, SUITE 2900 NEW ORLEANS LA 70163

AMCE PHYSICIANS GROUP- SLIDELL 1 436 OLD SPANISH TRAIL SLIDELL LA 70458-3904

AMCE PHYSICIANS GROUP-SLIDELL 2 PULMONARY HEALTH ASSOCIATES BLDG. 2240 GAUZE BLVD. EAST SLIDELL LA 70461 (b) (6) ALFRED E BUXTON PH D 155 HOSPITAL DR SUITE 200. LAFAYETTE LA 70503 GERALD B. BROUSSARD MD BROUSSARD CATARACT & EYE INSTITUTE 1250 PECANLAND ROAD MONROE LA 71203

W DONNER MIZELLE 225 N COLLEGE RD ACADIAN VISION ASSOCIATES LAFAYETTE LA 70506

LACOMBE EYE CENTER LLC 4400 D AMBASSADOR CAFFERY LAFAYETTE LA 70508

LAHAYE CENTER FOR ADVANCED EYE CARE 4313 I-49 S SERVICE RD OPELOUSAS LA 70570

AUDIOLOGY CONSULTANTS OF LA 1408 METRO DRIVE ALEXANDRIA LA 71301

CATHERINE PIERCE-AUDIOLOGIST 1408 METRO DRIVE ALEXANDRIA LA 71301

JOY TERRELL PHD 5618 SUPERIOR DR SUITE F BATON ROUGE LA 70816

WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD RESPIRATORY DEPARTMENT 2ND FLOOR MARRERO LA 70072

BARBARA MOOREHEAD PSYD BRAIN MATTERS 1419 MAIN ST. ALEXANDRIA LA 71301

MARK D FRUGE PH D 923 NAPOLEON AVENUE P O BOX 734 SUNSET LA 70584

AMY CAVANAUGH PHD (b) (6) LAFAYETTE LA 70508

ANDRE LONG OD (b) (6) PINEVILLE LA 71360

GARY GLEN FUTCH PHD (b) (6) ALEXANDRIA LA 71301

CARLOS KRONBERGER PH D 3520 GENERAL DEGAULLE DR SUITE 3024 3RD FLOOR NEW ORLEANS LA 70131

KEVIN ROGERS, O. D. ROGERS REGIONAL EYE CENTER 18901 GREENWELL SPRINGS ROAD GREENWELL SPRINGS LA 70739

JAMES L. ZUMBRUNNEN, MD 7925 YOUREE DR., SUITE 200 SHREVEPORT LA 71105

JOSEPH A LAMANNA ED D (b) (6) ALEXANDRIA LA 71301

ANDREW COMEAUX, LCSW 2625 LINE AVE SUITE 106 SHREVEPORT LA 71104

BATON ROUGE CLINIC 7373 PERKINS RD BATON ROUGE LA 70808

KEVIN TRIPEAUX LCSW ONE AMERICAN PLACE 301 MAIN ST. STE. 2200 BATON ROUGE LA 70802

WENDI RICHARDSON-SPEECH LANGUAGE PATHOLOGIST (b) (6) WEST MONROE LA 71291

LESTER C CULVER PH D - BOGALUSA (b) (6) BOGALUSA LA 70427

LESTER C CULVER PHD - NEW ORLEANS 2930 CANAL ST 3RD FLOOR NEW ORLEANS LA 70119

LESTER C CULVER PH D - MARRERO (b) (6) MARRERO LA 70072

LESTER C CULVER PH D - METAIRIE 3017 HARVARD ST FLOOR 1 METAIRIE LA 70006

LESTER CULVER PH D - COVINGTON (b) (6) COVINGTON LA 70433

M.B. THERAPY, INC. 1440 PETERMAN DRIVE SUITE A ALEXANDRIA LA 71303

HAMMOND HEART CLINIC 16033 DOCTORS BLVD HAMMOND LA 70403

CHARLES C. UGOKWE MD (b) (6) ALEXANDRIA LA 71301

JULANA D. MONTI, MD- MINDEN (b) (6) MINDEN LA 71055

JULANA D. MONTI, MD- LAFAYETTE (b) (6) LAFAYETTE LA 70508

JULANA MONTI, MD-BOSSIER CITY 3018 OLD MINDEN RD SUITE 1203 BOSSIER CITY LA 71112

DR. JOHN H WISE (b) (6) CROWLEY LA 70526

DR. JOHN H WISE (b) (6) RAYNE LA 70578

DR. JEFFREY C. FITTER 1234 DAVID DR. SUITE 103 MORGAN CITY LA 70380

SURGICAL EYE ASSOCIATES-COVI 1120 N US HWY 190 COVINGTON LA 70433

SURGICAL EYE ASSOCIATES FRANKLINTON 803 RIVERSIDE DR FRANKLINTON LA 70438

DARREL B. TURNER PH D BRAIN MATTERS 1419 MAIN ST. ALEXANDRIA LA 71301 (b) (6)DARREL B. TURNER, PHD (b) (6) LAKE CHARLES LA 70601 KICHEA S. BURT, LCSW BACS 2372 ST. CLAUDE AVE. SUITE 220 NEW ORLEANS LA 70117

TERRY O. THOMAS, PH.D. (b) (6) MONROE LA 71201

TAIRA WOODROFFE M.D. 4242 HWY 19, BLDG 3 SUITE A ZACHARY LA 70791

ALEXANDRIA EYE LASER 1008 SOUTH 6TH ST LEESVILLE LA 71446

OLYMPUS HEALTH SERVICES ALEXANDRIA 11 HEYMAN LANE ALEXANDRIA LA 71303

OLYMPUS HEALTH DERIDDER 311 S. PINE ST. DERIDDER LA 70634

ANDRIETTE FITCH MD 4336 NORTH BLVD SUITE 103 BATON ROUGE LA 70806

RAFAEL F. OTERO, PH.D (b) (6) TEXARKANA TX 75503

BEAU J. BAGLEY, MD 1331 OCHSNER BLVD. SUITE 100 COVINGTON LA 70433

CAROLA OKOGBAA MD 7855 HOWELL BLVD SUITE 130-A BATON ROUGE LA 70807

DAVID LANDRY PH.D 203 W. MAIN ST. SUITE 105 NEW IBERIA LA 70560

SHANNAE HARNESS, PHD- LAPL 232 BELLE TERRE BLVD. SUITE B LAPLACE LA 70068

SHANNAE HARNESS, PHD- HOU (b) (6) HOUMA LA 70360

SHANNAE HARNESS, PHD- RAC (b) (6) RACELAND LA 70394

SUSAN C. TUCKER, PHD 2040 LINE AVE SUITE 101 SHREVEPORT LA 71104

KTN MEDICAL, LLC 1718 N. MARTIN LUTHER KING HWY LAKE CHARLES LA 70601

CLAUDE FALLIS OD (b) (6) ABBEVILLE LA 70510

ANTHONY J PALAZZO M D (b) (6) BOGALUSA LA 70427-0370

GLENWOOD REGIONAL MEDICAL CENTER 503 MCMILLAN RD. WEST MONROE LA 71291

ST. CHARLES VISION (UPTOWN) 8040 ST. CHARLES AVE. NEW ORLEANS LA 70118

CAROL REDILLAS, MD (b) (6) CHALMETTE LA 70043

MARK A. SKELLIE, PSYD (N.O.) 137 N. CLARK ST. SUITE 4 NEW ORLEANS LA 70119

GNC THERAPIES INC-BATON ROUGE 301 NORTH MAIN ST, SUITE 2200 BATON ROUGE LA 70802

GNC THERAPIES, INC (N.O) 1615 POYDRAS STREET SUITE 900 NEW ORLEANS LA 70112

GNC THERAPIES, INC (MET) ONE GALLERIA BLVD SUITE 1900 METAIRIE LA 70002-1726

WEST JEFFERSON MEDICAL CENTER 1101 MEDICAL CENTER BLVD MARRERO LA 70072

SHERRY RUMBY, LPC (b) (6) MINDEN LA 71055

STEPHEN T. JONES, MD URGENT CARE ELEVEN 3218 ST. CLAUDE AVE. NEW ORLEANS LA 70117

JIMMY EATON O.D. 911 TECH DRIVE RUSTON LA 71270

GARY AVALLONE O.D. 911 TECH DRIVE RUSTON LA 71270

KRISTI GRAVES HUBBARD S&LP 1799 STUMPF BLVD. BLDG 5 SUITE 2 TERRYTOWN LA 70056

LISA FLEMING BANNISTER-SLP (b) (6) MONROE LA 71201

DERRICK STEVENSON, LCSW 8924 JEWELLA AVE ROOM 22W SHREVEPORT LA 71118

DORIS A. SMALL, LCSW 1760 TEXAS ST NATCHITOCHES LA 71457

SHARON BEARD, LPC 1760 TEXAS ST NATCHITOCHES LA 71457

KIMBERLY CARTER - SLP (b) (6) RAYVILLE LA 71269

MARTIN AUDIFFRED (b) (6) LAFAYETTE LA 70506

MICHAEL D. MCGILL, MCD, CCC-SLP 8730 YOUREE DRIVE, SUITE B SHREVEPORT LA 71115 (b) (6) NOLA HEARING 1700 VETERANS BLVD STE 200 METAIRIE LA 70005 DEBRA D. LAING, M.C.D., CCC-SLP (b) (6) SHREVEPORT LA 71105

ALETHA NELSON-LPC 908 NORTH 3RD ST. MONROE LA 71201

CAROLYN BRUCE-LPC 908 NORTH 3RD ST. MONROE LA 71201

ANTHEA JOSEPH-LPC 908 NORTH 3RD ST. MONROE LA 71201

DR JOHN F. LOUPE 2223 QUAIL RUN DR. STE G1 BATON ROUGE LA 70808

MAGNOLIA MEDICAL SERVICES SHREVEPORT 2121 FAIRFIELD AVE, SUITE 110 SHREVEPORT LA 71104

MAGNOLIA MEDICAL SERVICES MONROE 3001 ARMAND ST.SUITE C MONROE LA 71201

MAGNOLIA MEDICAL SERVICES - CROWLEY 207 EAST 5TH ST. CROWLEY LA 70526

MAGNOLIA MEDICAL- MORGAN CITY 2403 6TH ST. MORGAN CITY LA 70460

MAGNOLIA MEDICAL SERVICES- LEESVILLE ST. MICHAEL'S CENTER 105 WEST SOUTH ST. LEESVILLE LA 71446

MAGNOLIA MEDICAL- HOUMA FLYNN MANCEAUX ETC. - CHIROPRACTORS 6902 W MAIN ST HOUMA LA 70360

APRIL GILCHRIST, LPC-S, NCC 4859 SHED ROAD SUITE 500 BOSSIER CITY LA 71111

KIMBERLY HUTCHINSON (b) (6) LAKE CHARLES LA 70601

JOSEPH WARNER, LPC (b) (6) LAPLACE LA 70068

GEORGE W. HEBERT, PHD 411 SOUTH PRIEUR ST. SUITE 307 NEW ORLEANS LA 70112

BUDI SUGENG MD (b) (6) LAFAYETTE LA 70506

JAMES LEE HOOVER, ED.D. (b) (6) TEXARKANA TX 75503

GERALD NISSLEY, JR., PSY.D. 505 EAST TRAVIS ST, SUITE 208 MARSHALL TX 75670

DR. JENNINGS, PSY.D.SHREVEPORT 920 PIERREMONT RD, SUITE 205 SHREVEPORT LA 71106

GAIL G LEGER CCC SLP ST. CHRISTOPHER COLLEGE BUILDING 3419 NORTHWEST EVANGELINE THRUWAY SUITE A-5 CARENCRO LA 70520

DEBORAH A. MAYEUX-SLP 3654 GOVERNMENT STREET SUITE 10 ALEXANDRIA LA 71302

KERRY HYMEL-NESBIT MA LPC 501 RUE DE SANTE SUITE 4 LAPLACE LA 70068

SCHERELL SIMONET 606 COLONIAL DR SUITE B FLIP MY FROWN COUNSELING SERVICES BATON ROUGE LA 70815

DR. ALBERTO PALMIANO 2312 E MAIN ST. STE. B NEW IBERIA LA 70560

SARAH B. HUGHES, LPC-S (b) (6) NEW ORLEANS LA 70119

LANA JOSEPH AU.D CCC-A, MSHCM HIGH LEVEL HEARING TECHNOLOGY 5640 JEFFERSON HIGHWAY HARAHAN LA 70123

TODAY'S EYECARE LLC MALL OF ACADIANA/LENSCRAFTERS 5725 JOHNSTON ST., SUITE 2314 LAFAYETTE LA 70503

LYNN DAIGLE, LPC HOUMA (b) (6) HOUMA LA 70360

KENDRA MICHAEL MD TOTAL FAMILY HEALTHCARE 4336 NORTH BLVD. STE 103 BATON ROUGE LA 70806

MICHAEL W. PARKER PHD (b) (6) STRONG AR 71765

DR. MARVIN D. CLIFTON 10319 OLD HAMMOND HWY STE. B2 BATON ROUGE LA 70816

DR. HAROLD J. HEBERT JR. 501 JEFFERSON TER SUITE A 501 JEFFERSON TERRACE BLVD NEW IBERIA NEW IBERIA LA 70560

MONICA G. BAGLEY, MCD, CCC-SLP 1331 OCHSNER BLVD. SUITE 100 COVINGTON LA 70433

STEPHANY HILLMAN, PHD 1244 BARROW STREET SUITE 107 HOUMA LA 70360

MARC L ZIMMERMANN PH D 2798 O'NEAL LANE BLDG. D BATON ROUGE LA 70816

MONICA STEVENS, PHD 131 SOUTH ROBERTSON ST. 14TH FLOOR (MURPHY BUILDING) NEW ORLEANS LA 70112

SORRELLS AUDIOLOGY LLC 555 DR. MICHAEL DEBAKEY DR. STE 104 LAKE CHARLES LA 70601

AMANDA GALLAGHER, PH.D. 1440 CANAL ST SUITE 1000 NEW ORLEANS LA 70112 (b) (6)FERNANDO PASTRANA, PHD 310 HUEY P. LONG AVE. SUITE 107 GRETNA LA 70053 TRENISE HARRIS LPC-S HOPE AND HEALING COUNSELING CENTER 3349 RIDGELAKE DR SUITE 104 METAIRIE LA 70001

JILL GAUDET 2533 BERT KOUNS IND. LOOP, SUITE 104 SHREVEPORT LA 71118

CYNTHIA R. LINDSEY, PSY.D. 733 KEYSER AVE, SUITE 100 NATCHITOCHES LA 71457

ST. CHARLES VISION-BOUTTE 13322 HWY. 90 BOUTTE LA 70039

MICHAEL B. GALLAGHER, PSY.D. (b) (6) ALEXANDRIA LA 71301

MARY MUNGER, PHD (b) (6) METAIRIE LA 70005

JOSEPH KATZ LCSW MAYERS MENTAL HEALTH LLC 216 SAINT LANDRY STREET LAFAYETTE LA 70506

MAISA E. SHELMIRE, LCSW 7855 HOWELL BLVD SUITE 120 BATON ROUGE LA 70807

DR. ANDREW J. THRASHER III 2500 MAPLEWOOD DR. SUITE 1 SULPHUR LA 70663

PATSY HERNANDEZ, LCSW ST. CHRISTOPHER COLLEGE BUILDING 3419 NORTHWEST EVANGELINE THRUWAY CARENCRO LA 70520

HILLARY COOPER, M.A., CCC-SLP- RUSTON FYZICAL THERAPY BALANCE CENTERS 730 CELEBRITY DRIVE RUSTON LA 71270

HILLARY COOPER, M.A., CCC-SLP- JONESBORO FYZICAL THERAPY BALANCE CENTERS 900 PERSHING HWY. JONESBORO LA 71251

MAURA C. MIZE HOPE THERAPY CENTER 1727 IMPERIAL BLVD BUILDING 3 LAKE CHARLES LA 70605

JENNIFER BAUM-LPC VOLUNTEERS OF AMERICA 3704 COLISEUM BLVD ALEXANDRIA LA 71303

BLAKE A. BOOTH MD BATON ROUGE EYE PHYSICIANS 4848 NORTH BLVD BATON ROUGE LA 70806

DIANNA DUCOTE MS CCC SLP 401 NORTH ST CHARLES BLDG B 401 NORTH ST CHARLES ABBEVILLE LA 70510

CHRISTOPHER CENAC SR MD (b) (6) HOUMA LA 70361

JOSEPH L PALOTTA MD UNIVERSAL PLAZA 5211 ESSEN LANE STE 8A BATON ROUGE LA 70809

DOCTOR FAUST, MD MEDICAL RECORDS STE 600 2633 NAPOLEON AVE NEW ORLEANS LA 70115

TERRY L ROBERTS M A ROBERTS HEARING CLINIC 4007 PARLIMENT DRIVE ALEXANDRIA LA 71303

TERRY L. ROBERTS, M.A. ROBERTS HEARING CLINIC 1503 GOODWIN RD. SUITE 205 RUSTON LA 71270

WILLIS KNIGHTON MEDICAL CENTER ATTN: RESPIRATORY THERAPY 2600 GREENWOOD RD SHREVEPORT LA 71103

CARLOS B REINOSO PHD MEDICAL RECORDS 4517 LORINO STREET METAIRIE LA 70006

S F FONTENELLE III PHD-METAIRIE (b) (6) METAIRIE LA 70001

S F FONTENELLE III PHD-NEW ORLEANS N O SPEECH AND HEARING BLDG 1636 TOLEDANO ST NEW ORLEANS LA 70115

JANE V MCDOW OD WAL-MART VISION CENTER STORE 542 1901 TCHOUPITOULAS ST NEW ORLEANS LA 70130

JOHN P. SANDIFER, MD MID STATE ORTHOPAEDICS 134 E. 5TH ST. NATCHITOCHES LA 71457

MARK BOWEN OD (b) (6) JENA LA 71342

BARRY TILLMAN MD RIVERPARK MEDICAL CENTER 107 FRONT ST. VIDALIA LA 71373

TIMOTHY BARRY OD MEDICAL RECORDS 418 N. MAIN STREET JENNINGS LA 70546

RODERICK E ADAMS PH D (b) (6) PINEVILLE LA 71360

PSYCHOLOGICAL ASSESSMENT TREATMENT 1502 STUBBS AVENUE MONROE LA 71201

PSYCHOLOGICAL ASSESSMENT & TREATMENT 1502 STUBBS AVE. MONROE LA 71201

RIAZ M CHAUDHRY MD (b) (6) JENA LA 71342

LINDA C STEWART M D 604 CHEVELLE DRIVE SUITE C BATON ROUGE LA 70806

DAVID D CLARK ED D 4565 LASALLE ST. SUITE 302 MANDEVILLE LA 70471

MOLLIE WEBB SPEECH HEARING C (b) (6) SHREVEPORT LA 71103-4601

ROGELIO A CASAMA M D 537 KENTUCKY AVE SUITE A BOGALUSA LA 70427 (b) (6) GEORGE J HAAG PH D (b) (6) ALEXANDRIA LA 71301 GEORGE J HAAG PH D 805 STUBBS AVE. SUITE C MONROE LA 71201

SATYARTHI GUPTA M D HIGHLAND PARK PLAZA COMPLEX 1 STE 108 COVINGTON LA 70433

HAROLD R YORK M D 4937 HEARST SUITE 2A METAIRIE LA 70001

LABCORP OF AMERICA 11441 INDUSTRIPLEX BLVD STE 140 BATON ROUGE LA 70809

DR. MIA SINGLETON BEN ALL KIDS PEDIATRICS 920 N. MAIN ST. OPELOUSAS LA 70570

JARRETT JOHNSON OD PRIMARY EYE CARE 1530 N BROAD ST NEW ORLEANS LA 70119

WK PIERREMONT CARDIOLOGY 1811 E BERT KOUNS INDUSTRIAL LOOP STE 210 SHREVEPORT LA 71105

BETTER HEARING SYSTEMS 1000 CHINABERRY DR SUITE 103 BOSSIER CITY LA 71111

MEDICAL CENTER DIAGNOSTICS 67250 INDUSTRY LANE COVINGTON LA 70433

WILLIAM E FOWLER PHD MET 3351 SEVERN AVE STE 301 METAIRIE LA 70002

WILLIAM E FOWLER PHD HOUMA (b) (6) HOUMA LA 70360-6301

THE THERAPY GROUP 7843 PARK AVENUE SUITE A HOUMA LA 70364

ST FRANCES CABRINI HOSPITAL 3330 MASONIC DRIVE ALEXANDRIA LA 71301

ST FRANCES CABRINI OP LAB 2108 TEXAS AVENUE SUITE 1060 ALEXANDRIA LA 71301

SANDRA B DURDIN PHD BR 8676 GOODWOOD BOULEVARD SUITE 404 BATON ROUGE LA 70806

SANDRA B DURDIN PH D LAFAYETTE 2032 NE EVANGELINE TRWY RAMADA INN LAFAYETTE LA 70501

SANDRA DURDIN PH D HAMMOND 15706 PROFESSIONAL PLAZA AUDIOLOGY ASSOCIATES BUILDING HAMMOND LA 70403

LAUREN ARBOUR 8762 QUARTERS LAKE RD BLDG 12 BATON ROUGE LA 70809

LAUREN ARBOUR (b) (6) NEW ORLEANS LA 70119 MAINE DDS CE PROVIDER LIST FY 2017 JOHN AGEE PHD DAVID AXELMAN MD NADIR BEHREM PSYD RONALD BLUM MD JUSTIN CLARK DO FREEMAN COREY LCSW COUNTY PT - PAUL MARQUIS PT RYAN CORMIER PT SHERMAN-CLARK-LETOURNEAU PT KERRY DRACH PSYD JONATHAN FREEDMAN PHD REHABILITATION ASSOCIATES-FRED FRIDMAN DO DONNA GATES PHD ROGER GINN PHD ANNE PRATT GIROUX AUD JOHN HALE EDD NELSON HAAS MD DWAYNE HOGAN LCSW KAREN HOVER MD PETER IPPOLITI PHD ROBERT KAHL PHD PATRICIA KOLOSOWSKI PHD MAINE CENTER FOR INTEGRATED REHAB ELISE MAGNUSON PSYD RENATO MEDRANO MD JAMES MORAN EDD MARGARET MORRISON PHD CHRISTOPHER MUNCIE PSYD LARRY NEWMAN MD RICHARD PARKER PHD ROBERT PHELPS MD EDWARD QUINN PHD GARY RASMUSSEN PHD NICHOLAS REHAGAN PHD ARTHUR SCOTT MD SELECT PT BEVERLY SHERWIN PHD COREY SMITH PSYD JAMES SMITH DO SUSAN STIEFEL PHD IRA STOCKWELL MD RICHARD STOCKWELL DO LEYA LAVERRIERE NP NATACHA SOVETSKY-CHABOT NP TRENTON HPATRICIA RILEY APRN-CNP ALBERT MARIAN PA TINA GRIFFIN KATHY KOTAS MD PAMELA WANSKER DO JAMES WERRBACH PHD JAMES WHELAN PSYD JOSEPH WOJCIK PHD MICHAEL MCLAUGHLIN PHD BRUCE SAUNDERS PHD WORKMED JERRY LEBEL PA ERICA LANGLOIS LCSW

SPECIALTIES MIDCOAST MEDICAL GROUP ENT NORTHERN MAINE SPEECH MAINELY KIDZ PT SANDCASTLE CLINICAL AND EDUCATIONAL SERVICES ASSOCIATED EYE CARE ATLEE GLEATON EYE CARE MAINE EYE CENTER DOWNEAST EYE MIDCOAST EYE ASSOCIATES - BATH AND BRUNSWICK VISION CARE OF MAINE 5 LOCATIONS (BANGOR, PRESQUE ISLE, DOVER FOXCROFT, HOULTON, HALLOWELL EMMC AUDIOLOGY EMMC OTOLARYNGOLOGY MAINE GENERAL MEDICAL CENTER FOOT HILL CENTER -AUDIO/SPEECH MAINE GENERAL MEDICAL CENTER REHAB AND AUDIOLOGICAL DEPT MAINE GENERAL MEDICAL CENTER EDMUND ERVIN PEDIATRIC CENTER KENNEBEC EYE CARE EYE CARE MEDICAL GROUP MARK HAMMOND ENT ASSOCIATES RIVERSIDE EYE CARE 2 LOCATIONS MERCY ENT EYE CARE MAINE

SITE VISIT RANDOM SELECTION SITE VISITS/TOP 5 TOP 5 & Primary CE work MD DDS CE Provider List FY16

First Name Last Name Credentials Group Volume/Key Provider Onsite Review Removal for Cause

Mohammed Abuzahara MD Andres Aceituno MD Srinivas Addala MD Yasmin Ahmed MD AMCE Physicians Ruth Agwuna MD Mohammed Ahmed MD Adebowale Ajayi MD Damanhuri Alkaitis MD Christeen Allen PsyD Patrick Allen EdD Shivangi Amin MD Med Plus April Anderson SLP National Speech Language Janet Anderson PhD Eva Anderson PhD Key Provider - Volume Onsite Visit Psych Inc. Justin Anderson PsyD for FY17 FY17 Gail Anderson MD Mouhamad Annous MD Edward Ansel PhD Merrill Ansher MD Samina Anwar MD Michael April MD Sajid Arain MD Redlink Onsite Visit Daniel Arnheim PhD FY17 Riffat Ashai MD Chalita Attalah MD Redlink Rida Azer MD Deepa Balasubramaniam MD N'Dama Bamba MD Med Plus Memunatu Bangura MD Darpan Bansal MD Paul Barbera MD Tracy Bartlett SLP Therapy Source William Barrish MD Amit Bhargava MD Praveen Bolarum MD Med Plus Kelly Bonnette SLP Renee Bovelle MD Levi Breuer PsyD Glenwood Brooks PhD Jacinth Brooks PsyD Rebekah Brown MD Med Plus Stanley Brull MD Ilana Burgh PsyD Kenneth Burlingame PhD Onsite Visit FY17 - Psych Inc (Justin Tyler Calabrese PsyD Anderson) Tracey Calvo Clarke SLP Kimberly Campbell PhD AMCE Physicians William Canter PhD AMCE Physicians Renee Carr PsyD Key Provider - Volume Onsite Visit Nicola Cascella MD for FY17 FY17 Matthew Celozzi PhD Donna Chambers MD Renu Chandra MD Mahesh Chandra MD Tanu Chandra MD CE Provider Services Janis Chester MD Dennis Chodnicki MD Ashok Chopra MD Matthew Christian MD CE Provider Services Shawn Clausen MD AMCE Physicians Raymond Clifford MD Howard Cohen MD Doriscine Colley MD Joseph Cudjoe MD Med Plus Scott Daly MD Ephrem Daniel MD Ajit Das MD Saluja Medical Associates Rene Desmarais MD Robert Dewberry PhD Onsite Visit Shakuntala Dhir MD FY17 Miles Diller PhD Gloria Domingo MD Mary Donnelly PhD Michael Draughon SLP John Driscoll PhD Jonathan Dubin MD Erica Edelman PhD Michael Elman MD Clifford Essman PhD Michelle Estis PhD Jonathan Etter MD Victoria Eyler PsyD Camellus Ezeugwu MD Rebekah Farrar SLP National Speech Language Key Provider - CE Only Onsite Visit Redlink Jeremy Fenlon Owner for FY17 FY17 Dana Fensterman SLP National Speech Language Harvey Fernbach PhD Evelyn Fielding PhD Francis Fishburne PhD Gawin Flynn MD Robert Foster PhD Key Provider - CE Only Onsite Visit Carolyn Fox Owner Med Plus for FY17 FY17 Key Provider - CE Only Onsite Visit Claude Fox MD Med Plus for FY17 FY17 Ashley Fralen Owner EBS Shleia Freeman MD Linda Freilich MD Jodi French PsyD A. Jerry Friedman MD Wilfredo Gamez MD CE Provider Services Robert Ganter PhD Bridget Garrison AuD Allen genut MD Clarnece Ghris MD Denise Gooch MD AMCE Physicians Christopher Goodrich MD Victor Gong MD Ramana Gopalan MD Lenita Gorrell PsyD Catherine Graham PhD CCC-SLP Twhanna Green PhD Louis Grenzer MD Amy Gross SLP EBS David Gross MD Amanda Guenther SLP National Speech Language Nishi Gulati MD Suresh Gupta MD George Hajjar Jr MD Mary Hanisee MD Med Plus Jethalal Harkhani MD Deborah Harris PhD Shoaib Hashmi MD Irafan Hassen MD Shalena Heard PhD Jordan Heffez MD Key Provider - Volume Onsite Visit Lawrence Honick MD for FY17 FY17 Key Provider - Volume Onsite Visit Linda Hoopes Owner for FY17 FY17 John Hornbaker MD David Hoyt MD Saw Htun MD Richard Hunt Jr MD Carl Hurwitz PhD Nabeen Hussain MD Donna Ignelzi-Ferraro PhD James Isaacs MD Julian Jakobovits MD Mariflor Jamora MD Sukhpal Jassi MD Allan Jensen MD Christian Jensen MD Carola Jobe PsyD Raynell Johnson PhD Savinder Julka MD Chidinma Kabba MD CE Provider Services Zalman Kahn MD Key Provider - Volume Michael Kaiser PhD for FY17 Neha Kalaria MD Saluja Medical Associates Mohammad Kamsheh MD Vijay Kannan MD Hassan Kassamali MD Tahoora Kawaja MD Michael Kelleher MD Rashid Khan MD Shafaat Khan MD Suresh Khetan MD Michael Kennedy MD Brian Kim DO Suman King PhD Gary Klein MD Key Provider - Top 5 for Onsite Visit Leigh Knotts PsyD FY17 FY17 John Konikkara MD Redlink Anuja Kurichh MD Ajit Kurup MD Key Provider - Volume Onsite Visit Alan Langlieb MD for FY17 FY17 Gerald Lee MD James Lee MD Brooke Leiman SLP National Speech Language Steven Lerner MD Tamara Levin PsyD Weerasak Lima MD Robert Lisk MD Cheryl Lowman PhD AMCE Physicians David Lumsden MD Suhas Madhiraju MD AMCE Physicians Monica Maines CCC-SLP Matthew Malta MD Eric Marcalus MD Gladys Marcum SLP Brett Martin MD Med Plus Nalin Mathur MD Key Provider - Top 5 for Deborah Matthews PhD FY17 Sally Mays PhD Sally McBride PhD Key Provider - Volume Onsite Visit Nancy McDonald PhD for FY17 FY17 Philip McGann MD Harriet Meier MD Brandon Metcalf MD Martha Merrion PhD Sarah Michel SLP National Speech Language Shama Mittal MD Benhur Mohammed MD CE Provider Services Lanning Moldauer PhD C. Bernard Mond MD Jorge Mondino MD J. Renee Moneyhun MD Melanie Montemayor MD CE Provider Services Catherine Moore SLP EBS Akintunde Morakinyo PhD Tavia Morgan PsyD AMCE Physicians Anwar Mumtaz MD Farid Murshed MD Ernest Myers MD Fadi Nasrallah MD Angela Nduaguba-Ezumba DO Bruce Neckritz MD Ashley Nimmo SLP EBS Deborah O'Donnell PhD Lorraine Ofori-Awuah MD Sanjin Oh MD Marjorie Okum PhD Ikechi Okwara MD Adaku Onukogu MD Kelly Ooi SLP National Speech Language Sisom Osia MD David Ospital MD Theodore Osuala SLP Patricia Ourand PhD Frederick Parente PhD Mark Paris MD David Parver MD Pranav Patel SLP Jacqueline Paterson SLP Donna Paul MD Stephan Pavlos MD Michael Peimer MD/PhD Jane Peng PsyD Amber Penuel MD Rafael Perez-Mera MD Katherine Perry MD Annette Pham MD Key Provider - Volume Onsite Visit Sara Phillips PhD for FY17 FY17 Vaul Phillips MD Melissa Phillips Jordan PhD Arturo Pidlaoan MD David Plotkin MD Stacey Pollack PhD Shauna Pollard PhD Kenneth Pompilio MD Regina Presley AUD/CCC-A Sohail Qarni MD Key Provider - Top 5 for Onsite Visit Ebenezer Quainoo MD FY17 FY17 Bruce Rabin MD/PhD Joseph Raffetto MD Patricia Randolph PhD CCC-A Vani Rao MD Harvey Rapp PhD Anuradha Reddy MD

Vijayalakshmi Reddy MD Denise Revel MS, CCC-SLP Pedro Rivera-Velazquez MD Frances Rodriguez MD A. Miguel Rodriquez PhD Ada Rodriguez MD AMCE Physicians Paul Rogers PsyD Key Provider - Top 5 for Onsite Visit Gregory Ross MD CEI FY17 FY17 William Russell MD Bernard Rubin MD Richard Ruth PhD Benjamin Rutt PhD Jessica Safer SLP National Speech Language Daliah Salahuddin MD Daljeet Saluja MD Saluja Medical Associates Darshan Saluja MD Saluja Medical Associates Kimberly Sanschagrin JD/PhD Daljit Sawhney EdD/CCC-SLP Robert Scherr PhD Linda Schuerholz EDD Faith Schwartz MD Michael Sellman MD Mohammad Shafiei MD Vijay Sharma MD Arlyne Sher PhD, PA

Paul Short PhD AMCE Physicians (b) (6) Gerald Shugoll MD Key Provider - Volume Onsite Visit Will Shumway Owner CE Provider Services for FY17 FY17 Hoorie Siddique PhD Daljeet Sidhu MD Samaranayake Silverine MD Wanda Simmons-Clemmons MD CE Provider Services Iqbal Singh MD James Smith PhD AMCE Physicians Ajay Soodan MD Jillyan St. Laurent SLP EBS Key Provider - Top 5 for Melinda Stein PhD FY17 Robert Stephens MD Nicole Stern MD John Stokes MD Saluja Medical Associates Samuel Stoleru MD Bina Taibi MD Saluja Medical Associates Alla Taller MD Inna Taller MD Key Provider - Volume Onsite Visit Mikhael Taller MD for FY17 FY17 James Tansinda MD Laura Tanyi-Remarck MD CE Provider Services Mary Taylor-Ennis PhD Duane Thomas PhD Teresa Trabue PsyD Njideka Udochi MD Perfecto Valarao MD Lucy Van Voorhees MD Judy Versola-Russo PsyD Barry Walters MD Tracie Warnick CCC-SLP Craig Watkins MD Saluja Medical Associates Key Provider - CE Only Onsite Visit Sheldon Weinstock PhD for FY17 FY17 Charles Weng MD Jeffrey Wexler MD Alexander Whelan SLP National Speech Language Sarah White MD Jeffrey Wieland MD Mark Williams MD (b) (6)

Nellie Whitaker MD CE Provider Services Marcia Wolf MD Douglas Wright MD Ling Wu PsyD Anita Wyatt CCC-SLP Kendel Wylie-Pugh PsyD AMCE Physicians James Yan MD Mark Young MD Willie Yu MD David Zahm PhD AMCE Physicians Mohammad Zamani MD John Zampella MD CE Provider Services Charles Zeitler PsyD Britney Ziskind PhD AMCE Physicians Amy Zimmerman MD MD DDS CE Facility List FY16

Facility Name

Advanced Radiology Anne Arundel Medical Center Baltimore Heart Associates Baltimore Pulmonary Critical Care PA Bon Secours Hospital Calvert Memorial Hospital Chester River Hospital Community Radiology Associates, Inc. Diagnostic Imaging Services Dorchester General Hospital Franklin Square Hospital Center Frederick Memorial Hospital Harford Memorial Hospital Lifebridge Community Pulmonology LLC Maryland Healthcare Clinics Memorial Hospital of Easton Meritus Medical Center

Meritus Medical Laboratory (Hagerstown Medical Lab)

Northwest Hospital Center Peninsula Regional Medical Center Prince George's Hospital Center Pulmonary Consults of Hagerstown Shady Grove Radiologists Sonus Hearing Center St. Mary's Hospital Suburban Hospital Tri State Occupational Medicine Inc. Union Hospital of Cecil County University of Maryland Med Ctr Midtown Campus Washington Adventist Hospital Western Maryland Regional Medical Center WMHS Bradock Hospital Corp Massachusetts

Doctor's Name Lic Type Status (Top/Key Provider) Onsite Visits

Alfred, Pierre (Greenfield Eye Care Assoc.) M.D. Aliotta, Armand M.D. Anscombe, Roderick M.D. Bakow, Harry Ph.D Yes Bekken, Kaaren Ph.D Yes Berkowitz, Albert Ed.D Bevis, Judith Ph.D Top provider based on dollar volume Yes Bhembe, Xenia Johnson M.D. Yes Blackmon, Kahni Ph.D Yes Bohnert, Michael M.D. Broder, Steven N. Ph.D Top provider based on dollar volume Yes Brooks, Mark L. Ph.D Bucklin, Janet Psy.D Yes Cahan, David M.D. Carbone, Victor Ph.D Carnes, Maureen Ph.D Caron, Mark Ph.D Yes Carruthers, Wendelyn SLP Cattanach, Lynn Ph.D Channell, Shawn Ph.D Cohen, Geoffrey Ph.D Colburn, Marnee Ph.D Colcher, Susan Ph.D Top provider based on dollar volume Yes Copersino, Marc Ph.D Cordero, Astrid SLP Covington, Elizabeth (CHC) SLP Cox, Adam Ph.D Cusher, Alan (Med Plus) Ph.D Diaz-Torres, Bonnie (CHC) SLP Dudley, Desreen Psy.D Dunne, Barbara Ed.D Top provider based on dollar volume Yes Dunn-Riordan, Christine (CHC) SLP Fahey, John Ph.D Farizan, Morey M.D. Forteith, Doris (part of Vorpahl) Ph.D Gendlerman, Josef M.D. Gershberg, Rick Ph.D Glieberman, Oscar M.D. Glikstein, Violetta SLP Goldberg, Ronald M.D. Greiner, Jack D.O. Yes Guenther, Teena Ph.D Haas, Scott Ph.D Hastings, Lisa (CHC) SLP Hemani, Sadruddin M.D. Henderson-Kjellen, Kimberly Psy.D Key Provider- Top 5 provider based on dollar volume Hennessy, John P. Ph.D Hentoff, Steven Ph.D Hernandez, Ananda Psy.D Yes Hernandez, Frank Ph.D Yes Hernandez, Margarita Ph.D Hoekstra, Renee Psy.D Top provider based on dollar volume Yes Holloway, Robert Ed.D Top provider based on dollar volume Yes Horton, Timothy Ph.D Top provider based on dollar volume Yes Howland, Charles C. Ph.D I.M.A. M.D./Ph.D Ingle, David Psy.D Yes Iscan, Sureyya Ph.D Yes Jacques-Twichell, Kathy (CHC) SLP Jagelman Hunter, Jane Ph.D Top provider based on dollar volume Yes Jones, Wendell M.D. Kacprzak, Krzysztof M.D. Kay, Howard (Brockton Pediatrics) M.D. Keat, Jane Psy.D Yes Kent, David Psy.D Kissin, Miriam Psy.D Key Provider - Top 5 provider based on dollar volume Yes Kogan, Jacob Yacov M.D. Key Provider - Top 5 provider based on dollar volume Yes Komer, R. Roger M.D. Yes Kovalcik, Rimma Psy.D Key Provider - Top 5 provider based on dollar volume Yes Krueger, William P. Ph.D Top provider based on dollar volume Yes Kurlander, Karen Ph.D Yes Massachusetts

Doctor's Name Lic Type Status (Top/Key Provider) Onsite Visits

Lawson, Jasper Ph.D Yes Leibowitz, Janet Psy.D Yes LeJacq-Smith, Timothy Ph.D Lenhart, Sharyn M.D. LeSueur, L. Lynn Ph.D Yes Levy, Dean Ph.D Losada-Zarate, Gloria Psy.D Yes MacDonald, Marian Ph.D Markey, Sean Ph.D Top provider based on dollar volume Yes Markosian, Nahid Ph.D Top provider based on dollar volume Yes Marks LeConey, R. Cindy (lic # 7980) Ph.D Mayers, Felix M.D. Mondale, Jason M.D. Yes Mora De Jesus, Rafael (Hartford Psychological Svcs) Ph.D Morgenstern, Doris (CHC) SLP Morocco, Daniel Ed.D Murray, Shannon Psy.D Natapov, Irina M.D. Norris, Ronald M.D. Nowell, David D. Ph.D Top provider based on dollar volume Yes Ober, Richard Ph.D Yes O'Connor, William E. M.d. Ojutalayo, Ayobami M.D. Yes Oladipo, Olarewaju M.D. Yes Osofsky, Robert M.D. Parsons, John Ph.D Peifer, Darcy (part of Vorpahl) Ph.D Pittenger, Sol Ph.D Top provider based on dollar volume Yes Powell (Harvey), Lashanda (Hartford Psychological Svcs) Psy.D Powers, Edward Ph.D Top provider based on dollar volume Yes Quamina, Benjamin Andre M.D. Quinn, Sarah A. Ph.D Rahman, M. Anis M.D. Riad, Mamdouh M.D. Roache, Caitlin (part of Vorpahl) Ph.D Robertson, Leah Ph.D Robison, James M.D. Yes Roselli, Anthony M.D. Yes Rosenblum, Debra M.D. Rosenthal, James M.D. Rothfarb, Herbert Ph.D Rusnak, Stanley Ed.D Salusti, Donna Psy.D Yes Saris, Stephen M.D. Saxena, Asha M.D. Schuetz, Richard Ph.D Schultz, Kristin Psy.D Slavit, Michael Ph.D Yes Smith, David A. Ph.D Smith, Michael SLP Sokol, Mark Ed.D Top provider based on dollar volume & Key Provider primary does CE's Yes Steinmark, Andrew Psy.D Yes Stephenson, Margaret Ph.D Stillson, Richard Ph.D Strominger, Mitchell M.D. Stronach, Theodore Ph.D Top provider based on dollar volume & Key Provider primary does CE's Yes Sutcliffe, Ernest M.D. Taylor, Milton Ph.D Key Provider primary does CE's Todd, James M.D. Toledo, Mabel (Hartford Psychological Svcs) SLP Key Provider - Top 5 provider based on dollar volume Vallery, Sandra Ph.D Vorpahl, Jacqueline Ph.D Wahlund, Thomas Psy.D Key Provider primary does CE's Warren, John (Franklin Eye Care Assoc.) M.D. Waters, Richard Psy.D Weene, Lawrence M.D. Weida, Alexandria Ed.D Whipple, Donna Psy.D Yes Whitworth, Don Ph.D Massachusetts

Doctor's Name Lic Type Status (Top/Key Provider) Onsite Visits

Williams, Douglas N. Psy.D Woodacre (O'Brien), Emily (CHC) SLP Yufit, Vladimir (Southcoast Physician Svcs) M.D. Yes Zarnoch, Chester M.D.

No longer contracting but performed CE's during the year:

Albin, John M.D. Basta, Nabil M.D. Bowie, Mark M.D. Brown, Peter A. Ph.D Yes Carlson, Katrin Ph.D Christian-Bratwaite, Nicole M.D. Ciri, Molly Psy.D Davies, Jeffrey M.D. Endriga, Raul M.D. Faherty, Ellen Psy.D Grillo, George M.D. Gutowski, Stanley Ph.D Hager, Joanne Ph.D Hulseberg, Kevin M.D. Husson, David Psy.D Top provider based on dollar volume & Key Provider primary does CE's Yes Kahn, Michael M.D. Kouperschmidt, Larisa M.D. Yes LaFlamme, Elise (Med Plus) M.D. Leeds, Svetlana Ph.D Matos, Greg Psy.D Matthews, Rebecca Ph.D Morin, Gregory Ph.D (b) (6) O'Brien, Paul Ed.D Olden, Lindsay (Wright) Ph.D Oropeza-Diaz, Yashira Psy.D Perry, Catherine Ph.D Yes Perry, David Ph.D Yes Piascik, Tiffany Ph.D Shea, Leo Ph.D Tenenbaum, Simon M.D. Thomson, Donald J. M.D. York, Richard Ph.D Zina-Duarte, Jessica M.D. Yes Michigan DDS - Audiologists Calhoun, Monseille Dalecki, Renee A Ellis, Sonya Larsen, Margaret Michigan DDS - Facilities 7C Lingo AAA Evaluations * Ace Psychological Consultants Akasha Medical Consultants PC* KEY Allegiance ENT Key Provider (Top 5) AMCE Physicians Group Key Provider (Primary CE work) Associates in Humanistic Psychology* (Terry Rudolph) *onsite visit completed FY 17 Battle Creek Counseling * Bright Horizons Psychological Center Burman and Zuckerbrod Ophthmology Comprehensive Psychological Services Dearborn ENT Diagnostic Evaluation Services * Disability Consultants, P.C. Ear, Nose, Throat and Plastic Surgery Assoc.* ENT Consultants Eye Associates Marquette Great Lakes Eye Care Great Lakes Eye Institute* Great Lakes Medical Evaluations * Hackley Workplace Health Holt Eye Care PLLC Hour Transportation Human Capabilities Corporation * Human Resource Associates John R. Medical Clinic Kalamazoo Psychological LLC Lakeshore Ear, Nose and Throat Center, PC Lansing Ophthalmology Lifetime Eyecare Lung Associates, P.C. Medical Care Plus * Medical Rehabilitation Group Michigan Medical Consultants * Michigan Medical Evaluation Mid-Michigan Ear, Nose and Throat Monarch Evaluation Services * Munson Community Health Center Novi Health Center, PC Old Town Psychological Services Port Huron Ophthalmology Psycho-Educational Consutant Service Psychological Resource & Testing Consultants Resolute Interpreting Ronan Psychological Associates * Rontal Akervall Clinic Saginaw Psychological Services * Seasons Counseling Center * Sermic Psychological * Sierra Medical Group * South Michigan Ophthamology Southern Michigan ENT, PC Superior Ear, Nose and Throat Specialist Tri-State Occupational Medicine, Inc. * Vision Eyecare Vision Institute of Michigan VPS of MI PLLC Weber and Devers Psychological Services Wilkinson Eye Clinic Workplace Health Wyandotte Eye Clinic Michigan DDS - MDs and Dos Batah Fouad Best Todd T KEY Blum George MD Key Provider (Top 5) Borovik Harry R Key Provider (Primary CE work) Buchman Clifford M *onsite visit completed FY 17 Campbell Vern J Carlson Waldo MD Cho Sung-Ran Dawis Elvira Dragoo Bruce D Fawcett Robert Friedman Neil A Goebel Eric Hillelson June D Lerchin Cheryl D Lopatin Fred L Qureshi Tanvir I Rocco James Sayyid Samiullah H MD Tinney Roderic MD Wahl Larry H DO Waitzman Ariel MD Michigan DDS - Optometrists Miller Bernard OD

Scarbrough Family Eye Care Wyandotte Eye Michigan DDS - Psychologists Abramsky Atara Ajayi-Nabors Margaret Bechard Joseph A Bonanno Shelly KEY Brooks Lois Key Provider (Top 5) Brown Bonnie Brown Craig Key Provider (Primary CE work) Bush Allison *onsite visit completed FY 17 Camp William L Caputo Janette S Cashbaugh * David LLP Croce Michelle L Cullen-Ott Mary Decker Patricia Emerson Lynne E Findley James Gardner* Nancy Gensterblum Anthony Goergen Marianne T Griffith Robert L Gventer Dawn B Hackworth Bruce Hayes Michael P Haynes Jack P Horner* Thomas M Inman Michael Jacobson* Bruce N James Richard Jeter* John D Kantor Anne G Kilpela Gary S Kinzie Wayne B Kirzner Gerald S Kitchen Paul S Koenig-Forbis Nancy Kroemer Henrike Lehmann Carol J Lozer James V Macleod Eric Majerczyk Brian Dale Makie Erik Markowicz Jocelyn A PhD McAndrews Lynn PhD McCulloch Leonard J Murphy Patrick Oliver-Brannon Gayle Pekrul* Kathryn Pestrue George E Peterson Glen* Potts David Reilly Neil J Reppuhn Steven D Ridella-Mehlos Sharon J Rosenbaum Thomas S Rosenweig Melissa Slamika Staci PhD Sommerschield Harold S Van Horn Firoza B Vander Woude Kenneth W Walberer Daniel L Wheeler Samantha FLP Zaroff Mark Zimostrad Scott Michigan DDS - SLP Babcock Ann M Bloom Richard Champagne Arthur Chapman Coleen Chevillet Sharon Cohen-Babcock Jodi Dahlman Susan Denis Rachel Edwards Patricia Ellis Stacy Eurich Kathleen Glonek Sarah Goletz Aira Gould Carol L Handren Shelley Harper Melanie Hartley Julie SLP Jaynes Beverly Kilmer Cynthia Lang Jason Maisel Teresa SLP Martin-Kobessi Kathi Mellen Penny Mosier Nancy SLP Murphy Rachel L O'Leksy Gail Pollich Kristen Popma James Robertson Phyllis Robbins Amy R KEY Saidi Samah M SLP Key Provider (Top 5) Scow Cecilia H Key Provider (Primary CE work) Shier Connie Smith Michele E *onsite visit completed FY 17 Spencer Susan Toth Kathleen Vanorman Amy SLP Vermeulen Linda SLP Weeden Annette Winegar Rebecca

Carl's Speech and Language Certified Speech Therapy Services Speech Pathology Assoc. Superior Rehabiitation and Prof Serv MI DDS FY 2017 - Testing

Greater Flint Imaging dba Lindent Rd Mid Michigan Radiology Assoc. OMH Speciality and Diagnostic Clinic Otsego Memorial Hospital Regional Medical Testing St, Marys of Michigan West Branch Regional Medical Center Minnesota FY 2017

VENDOR_NO NAME EXAMS Top 10 Provider Onsite Visit A TO Z WORLD LANGUAGES INC 13 (b) (6) ABBAS, CAITLIN 1 ABDULWAHAM, ADEEM 1 ABRAHAM, DENNIS MD 1 ALBERIO, KATHLEEN 2 ALLEN, BRIAN DO 77 ANDERSEN, DENNIS MA 146 ALTRU CLINIC GRAND FORKS 1 ANDERSEN, SALLY SLP 19 ANDERSON, ANNIKA E OD 3 ANDERSON, CASSIE SLP 4 ANDERSON, CHRISTOPHER MD 1 ANDERSON, MARK 55 ANDERSON, STEVEN MD 2 ANGLE, REBECCA PHD 39 ANHORN, JENNIFER SLP 2 ARCH LANGUAGE NETWORK 9 BACHMAN, ANNA 8 BACHMEIER, ERIK 25 BACKLAS, TYLER 2 BALDUS, JAMES PHD 46 BARNES, MADALINE PHD 10 BARRON, DR CRAIG 1059 Yes 7/28/2015 BARRON, ROBERT C PHD 266 Yes 9/3/2015 BARSTAD, TRENT PHD 7 BARTH, TARA OD 28 BAUER, MATTHEW OD 38 BECKEN, ERIC THOMAS MD 6 BOETTCHER, BRITTANY OD 21 BONTE, BRIAN MD 87 BOOTH, JILL SLP 6 BOURDEAUX, MONIQUE PHD 988 9/8/2015 BOWMAN, SARAH 54 BREITENBUCHER, MARY PHD 5 BRIDGE WORLD LANGUAGE CENTE 103 BROCKMAN, HEATHER 11 BUBOLTZ, MARK OD 34 BUTSON, STEPHANIE 1 CABRERA SVENDSEN, MATTHEW 3 CABRERA, SHANNON 2 CARLIN, SUSAN M SLP 20 CARLSON, BETHANY 1 CARLSON, DANIEL L 60 CARLSON, SHERIE LP 70 CARROLL, PATRICK J MS 179 CASPERS, DIANE LP 14 CAVEN, ELIZABETH J PSYD 31 CHESLOCK, GERMAINE 2 CHRISTIANSEN, TIMOTHY N 10 CLARITY INTERPRETING SERVIC 5 CLOUTIER-GILL, NOUMIA OD 15 COCKER, RICHARD MS 29 COMMUNICATION SERVICE FOR D 25 COX, JOSEPH PSYD 101 COX, VICTOR STUART 25 CRAGLE, STEPHEN MD 8 CROSS CULTURAL MEDICAL INTE 19 CURTIS, STEVEN B 48 DARVEAUX, DION LP 33 DAUER, EILEEN MD 8 DEARKING, AMY C MD 8 (b) (6) DESMONDE, MARCUS PSYD 87 DICKSON, WILLIAM J PHD 109 DOEDEN, GINA OD 19 DULUTH CLINIC VIRGINIA 1 DVORAK, JOHN A 11 EDELSON, DOROTHY PSYD 44 EGLI, ANDREA PHD 10 EICHLER, MICHAEL MD 2 ESSENTIA HEALTH ST MARYS HO 22 FAUL, KIRI ANN PHD 1 FERRY, LOUISE PHD 27 FISCHLER, GARY PHD 7 FLOHR, JAMIE MD 42 FLORES, JANIE 2 FREDRICKSON, SARA OD 9 GAUTHAM, SHANTA MD 2 GENDRON, KRISTIN MD 28 GERHARDT, JENNIFER 44 GLYNN, CHRISTINE 1 GOMAN, KRISTEN 10 GRAHAM, JOHN A MS 34 GRAND ITASCA CLINIC & HOSPI 4 GRANITE FALLS MUN HOSPITAL 6 GREEN, LARRY LP 73 GUNDERSON, LAURA 1 HAINES, KAYLA 1 HAMILTON, PAMELA 6 HAMLIN, FALICIA 1 HANSON, RONALD MD 4 HEALY, ANNE 2 HILBRAND, ASHLEY MD 3 HINZE, TRAVIS PHD 20 HOBBS, JOHNNA 3 HOFFMAN, KRISTINA SLP 2 HORECKA, RICHARD MD 43 HOWK, LUPY 1 HUBER, JAMES PHD 426 Yes HUNTER, PATRICIA PHD 18 IMMANUEL ST JOSEPHS HOSPITA 13 ITASCA INTERPRETING SERVICES 201 IVERSON-HILL, SONJA OD 1 JANKUS, WARD R 1022 Yes 8/27/2015 JOHNSON, A NEIL MD 2573 Yes 9/18/2015 JOHNSON, ANNIE MA 6 JOHNSON, BRENT D 1 JOHNSON, NENA 16 JOHNSON, SUSAN MD 216 8/18/2015 JOHNSTAD, MARIE SLP 31 JOPLIN, ANDREA 7 JOSEPH, THRESIAMMA 4 KAHLER, RONALD LP 36 KARAYUSUF, ALFORD 2752 Yes 8/10/2015 KARLEN, RICHARD MD 2 KARPYAK, TATYANA PSYD 94 KEARNEY, MICHAEL M 45 KELLY, BRANDON OD 13 KEYSTONE INTERP SOLUTIONS I 64 KIRCHNER, JOEL PSYD 185 KRAMLINGER, MARY 1 KOENIG, MIKAELA MD 1 KRENIK, SARAH SLP 6 (b) (6)KRUEGER, NICOLE 4 KULLA, KAREN 36 LAKE REGION HOSPITAL 5 LANE, STEPHEN S MD 1 LANG, JACOB R OD 3 LARSON, ROBERT MD 1 LAVALLIE, SEAN OD 9 LEAVECK, APRIL S PSYD 27 LEE, ANNIE MD 1 LEINONEN, CAROL L PSYD 46 LIEF, JENNY 1 LOPNO, ROBERT L II 163 LYNCH, JEFFERY MD 1 LYSNE, MARK PHD 139 MAGNUSON, TODD 8 MANGIAMELE, SEBASTIAN MD 239 MARQUARDT, JAMES 5 MARION, MITCHELL MD 8 MARSHALL, LINDA PHD 32 MARTENS, KENNETH L MS 142 MARTIN, MARK D0 40 MAYO CLINIC HEALTH SYSTEM A 7 MCCABE, WENDY 10 MCNELIS SAVRE, LORI SLP 8 MELANDER, MCKENZIE 15 MERCY HOSPITAL 31 MEYER, KRISTINE M MA 108 MIDWEST EAR NOSE & THROAT S 1 MIDWEST INTERP/TRANSLATION 992 MILLER, SARAH 8 MISKAVIGE, LINDSEY SLP 5 MODAHL, ED LP 36 MONTEALEGRE, KATE OD 7 MONTELIBANO, SHELLY 7 MOONEY, RENE PSYD 3 MORAN, DEBRA LP 114 MORIN, MATANA 8 NORENBERG, KAYLA MD 4 MURPHY, JESSICA L OD 3 OKNER, THOMAS MD 3 OLSEN, ROGER A PSYD 87 OLSON, SPENCER ANTON PSYD LP 124 8/8/2017 OREGAN, JOHN T 297 OWATONNA HOSPITAL 45 PAPENFUSS, JANET 3 PHILLIPPI, JAY 50 8/2/2017 PIEH, TIMOTHY 14 PROJECT FINE 30 RADEMACHER, MARY MS 4 RAMTHUN, STACIE 18 RESSLER, SCOTT LP 34 8/2/2017 REYNOLDS, ABIGAIL MD 3 RICE MEMORIAL HOSPITAL 2 RICE REHABILITATION CENTER 25 RIDGEVIEW MED CENTER 2 RIES, ADAM LP 5 RIGGS, SHAINA MD 1 RIVERVIEW HOSPITAL 12 RONDLA, SUCHITRA 3 ROWAN, LESLIE PHD LP 71 SABIR, DAVID 9 (b) (6) SANFORD BEMIDJI MED CENTER 151 SANT, SAMUEL 6 SARFF, PHILIP PHD 205 SAUNDERS, MARY 5 SCHAFER, RYAN LP 132 8/10/2017 SCHULER, MARK PHD 156 SCORE, KATHRYN MD 1 SCURRY, WILLIAM PHD 93 SHELHAMER, LEONARD E 1 SKOPHAMMER, HEIDI SLP 19 SMITH, ROBERT MD 24 SPANIER, DIANE 2 SPEECH LANGUAGE PATHOLOGY D 269 ST CLOUD HOSPITAL 12 ST CLOUD MED GROUP 93 ST GABRIELS HOSPITAL 2 ST LUKES HOSPITAL 2 ST PAUL PULMONARY DIAGNOSTI 70 STEVENS, MARY LOUISE 18 STICH, SHERREY 9 STREITMAN, SANDRA LP 100 STROM, JANELLE OD 24 STUBENVOLL, ROBERT 7 SWITRAS, JOSEPH E PHD 47 THIBODEAU, ALYSSE 10 YHOMALLA, ANTHONY 6 THOMPSON, SEAN 15 TOREN, ALISON PHD 3 TRUITT, THEODORE MD 5 TRULSEN, MARLIN O PHD 1037 Yes 8/11/2017 UNIV MED CENTER MESABI 4 VAN NOORD, CHERYL SYBESMA L 127 VAN NOORD, ROBERT G PHD 172 WAGNER, LYLE III LP 115 9/20/2017 WAGNER, LYLE W PHD 325 Yes 9/20/2017 WALLACE-REED, RITA MD 142 WARNER, DUSTIN J PSYD 704 Yes 7/27/2017 WATSON MILLER, REBECCA J PH 25 WERNER, HEIDI MD 2 WICKERSHAM, JENNA OD 4 WIGER, DONALD PHD 1762 Yes 8/8/2017 WINONA HEALTH SERVICES 8 WINTER, MELISSA PSYD 21 WINTERS, PATRICIA M OD 1 WOLNER, BRAD 7 WU, CHARLIE MD 20 YERKA, ED PHD 138 YOHE, MARK MD 166 YOSHIDA, GLEN Y 4 Missouri FY 2017

Vendor ID Organization Name First Name Last Name City State AQEEB AHMAD BRIDGETON MO (b) (6) FRANCES ANDERSON SPRINGFIELD MO MICHAEL ARMOUR CLAYTON MO SUSAN BARNGROVER LEES SUMMIT MO ANNA BELLATIN KANSAS CITY MO JOE BENNETT SEDALIA MO JENNIFER BIERE MOBERLY MO JENNIFER BIERE SALISBURY MO C WILLIAM BRECKENRIDGE KANSAS CITY MO LAURA BRENNER COLUMBIA MO RONALD BUENING SEYMOUR MO LAWRENCE COHEN KANSAS CITY MO JERRY CUNNINGHAM POPLAR BLUFF MO JERRY CUNNINGHAM FENTON MO KALA DANUSHKODI N KANSAS CITY MO MANISH DIXIT PARSONS KS NINA EPPERSON LIBERTY MO ROBERT FORSYTH SPRINGFIELD MO D FRISBIE JOPLIN MO CHAD GERHART JOPLIN MO BRYCE GRAY HANNIBAL MO BRYCE GRAY NEVADA MO BRYCE GRAY COLUMBIA MO BRYCE GRAY SEDALIA MO KELLEY GRAY CRYSTAL CITY MO ALISE GRAY COLUMBIA MO GARY HACKNEY WICHITA KS KAREN HAMPTON ST LOUIS MO JEFFREY HARDEN KIRKSVILLE MO WILLIAM HUGHES JOPLIN MO YUNG HWANG CARTHAGE MO YUNG HWANG SPRINGFIELD MO ALAN ISRAEL KANSAS CITY MO KAREN JORDAN OVERLAND PARK KS CAROLYN KARR NEVADA MO LOUIS KRENN JR WILLARD MO V NANDA KUMAR ST JOSEPH MO ROBERT LACKAMP SEDALIA MO TIMOTHY LEONBERGER ST LOUIS MO ROBERT LEWIS ST LOUIS MO LYNN LIEBERMAN KANSAS CITY MO DAVID LINSENMEYER DODGE CITY KS JOHN LUCIO JEFFERSON CITY MO CHRISTOPHER MAGLIO KIRKSVILLE MO JOSEPH MCCORMACK JEFFERSON CITY MO JOI MCNELEY-PHELPS LENEXA KS STANLEY MINTZ LEAVENWORTH KS STANLEY MINTZ LAWRENCE KS RUTHIE MOCCIA COLUMBIA MO JASON NEUFELD OVERLAND PARK KS ALLEN PARMET KANSAS CITY MO DAVID PEACO WENTZVILLE MO RANDALL POHLENZ TOPEKA KS JAMIE PRESTAGE KANSAS CITY MO DAVID PULCHER OVERLAND PARK KS PAUL REXROAT ST LOUIS MO JONATHAN ROSENBOOM CHILLICOTHE MO MARTIN ROSSO FLORISSANT MO KEN RUBENACKER SIKESTON MO JANE RUEDI BLUE SPRINGS MO DOMINICK SCALISE OLATHE KS TODD SCHEMMEL OLATHE KS MARK SCHMITZ COLUMBIA MO WALTER SCHROEDER JR CAPE GIRARDEAU MO LINDA SCHULTZ MOBERLY MO LINDA SCHULTZ BOONVILLE MO MICHAEL SCHWARTZ KANSAS CITY MO MICHAEL SCHWARTZ ST JOSEPH MO MICHAEL SCHWARTZ SALINA KS MICHAEL SCHWARTZ OVERLAND PARK KS RAMESH SHAH JOPLIN MO THOMAS SPENCER JEFFERSON CITY MO CRAIG SPIEGEL BRIDGETON MO RUTH STOECKER ROLLA MO S SUBRAMANIAN CARTHAGE MO RICK THOMAS BELTON MO RICK THOMAS LIBERTY MO RICK THOMAS LIBERTY MO (b) (6) RICK THOMAS KANSAS CITY MO JAMES TICHENOR KIRKSVILLE MO LAURA TISHEY CLAYTON MO PRISCILLA WALLINGFORD LEAWOOD KS STEVEN WALTERS GREAT BEND KS CHRIS WEBER BRANSON MO BROOKE WHISENHUNT SPRINGFIELD MO 247 PC CHICAGO IL A RASHID QURESHI MD INC A RASHID QURESHI ST LOUIS MO ACADEMIC MEDICINE INC KIRKSVILLE MO ADELMAN & ASSOCIATES STEVEN ADELMAN VERSAILLES MO ADVANCED NATURAL HEALTHCARE JOHN BRANDT WEST PLAINS MO ADVANCED NATURAL HEALTHCARE RICHARD FREDERICK WEST PLAINS MO ADVANCED PHYSICAL THERAPY JOSHUA HOCKETT BLUE SPRINGS MO ADVANCED PHYSICAL THERAPY TIMOTHY ROBERTS BLUE SPRINGS MO ADVANCED PHYSICAL THERAPY TRAVIS RUMP BLUE SPRINGS MO ADVANCED RADIOLOGY LLC OSAGE BEACH MO ADVANCES IN THERAPY AMY FLESHMAN KIRKSVILLE MO AFFINIA HEALTHCARE-BIDDLE ST LOUIS MO AFFINIA HEALTHCARE-LEMP ST LOUIS MO ALLIANCE RADIOLOGY KANSAS CITY MO APEXNETWORK PHYSICAL THERAPY JOHN TOCCI SPRINGFIELD MO APPLIED PSYCHOLOGICAL CENTER DAVID VAN PELT CAPE GIRARDEAU MO AREA HEARING & SPEECH CLINIC JOPLIN MO ASSESSMENT CONSULTANTS LLC AMY FISCH KANSAS CITY MO ASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER ROLLA MO ASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER WASHINGTON MO ASSOC BEHAVIORAL CONSULTANTS THOMAS SPENCER ST CHARLES MO ASSOCIATED BEHAVIORAL CONSULT NINA EPPERSON ST JOSEPH MO ASSOCIATED BEHAVIORAL CONSULTA THOMAS SPENCER PEVELY MO ASSOCIATED BEHAVIORAL HEALTH THOMAS SPENCER HANNIBAL MO ASSOCIATED BEHAVORIAL CONSULT THOMAS SPENCER CRYSTAL CITY MO AT STILL UNIV-GUTENSOHN CLINIC STEPHEN BERGMAN KIRKSVILLE MO ATCHISON HOSPITAL ASSOCIATION ATCHISON KS AUDIOLOGY & HEARING AID SERV WICHITA KS AUDIOLOGY & HEARING CENTER KELLEY GRAY FARMINGTON MO AUDIOLOGY CENTER CAPE GIRARDEAU MO BATEK FAMILY EYE CARE SHARON BATEK FULTON MO BLUFF RADIOLOGY GROUP POPLAR BLUFF MO BODENHAMER EYE CONSULTANTS BRET BODENHAMER JEFFERSON CITY MO BOLIVAR PHYSICAL THERAPY BOLIVAR MO BOONE HOSPITAL CENTER COLUMBIA MO BOONE HOSPITAL CENTER COLUMBIA MO BOONE HOSPITAL CENTER COLUMBIA MO BOONE HOSPITAL CTR COLUMBIA MO BOOTHEEL EYE CARE JUSTIN SCHROEDER CARUTHERSVILLE MO BOTHWELL REGIONAL HEALTH CTR SEDALIA MO BOTHWELL REGIONAL HEALTH CTR SEDALIA MO BROOKSIDE COUNSELING RICK THOMAS KANSAS CITY MO BURRELL KINGSLEY CLINIC CHRISTINA PIETZ SPRINGFIELD MO BURTON CREEK RURAL CLINIC BRUCE PRESTON WEST PLAINS MO BUTLER-DAVIDSON COUNSELING SER LINDA DAVIDSON NEVADA MO CAMERON REGIONAL MED CENTER CAMERON MO CAMERON REGIONAL MED CENTER CAMERON MO CAPE GIRARDEAU PUBLIC LIBRARY JENNIFER STEELMAN CAPE GIRARDEAU MO CAPE MEDICAL WEIGHT LOSS & FP DEBBIE EVANS CAPE GIRARDEAU MO CAPE RADIOLOGY GROUP INC CAPE GIRARDEAU MO CAPITAL REG MED CTR-HEALTHPLEX GWEN MOE JEFFERSON CITY MO CAPITAL REGION MED CENTER JEFFERSON CITY MO CAPITAL REGION MED CTR JEFFERSON CITY MO CAPITAL REGION MED CTR JEFFERSON CITY MO CAPITAL REGION MED CTR-STILL JEFFERSON CITY MO CARDIOVASCULAR CONSULTANTS CAPE GIRARDEAU MO CASSVILLE BRANCH LIBRARY JAMES CARPENTER CASSVILLE MO CENTER OF ORTHO EXCELLENCE GREGGORY KUHLMANN JEFFERSON CITY MO CENTRAL MEDICAL CONSULTANTS WICHITA KS CENTRAL MEDICAL CONSULTANTS TOPEKA KS CENTRAL MEDICAL CONSULTANTS SHAWNEE MISSION KS CENTRAL MO ENT & SINUS PC ROBERT MCDONALD JEFFERSON CITY MO CHAFFEE HIGH SCHOOL LANA ATKINS CHAFFEE MO CHRISTIAN HOSPITAL NE ST LOUIS MO CHRISTIAN PSYCH SERVICES OF KC DON BRADY BLUE SPRINGS MO Citizen's Bank building 2nd fl LYNN LIEBERMAN KANSAS CITY MO CITIZENS MEDICAL CENTER COLBY KS CITIZENS MEMORIAL HOSPITAL BOLIVAR MO CITY SPEECH INC CLAYTON MO CLINICAL ASSMNT PSYCHOLOG SVCS JOHN WOOD POPLAR BLUFF MO CLINICAL RADIOLOGY CONS INC SEDALIA MO COLBY DCF OFFICE MICHAEL SCHWARTZ COLBY KS (b) (6) COLLEGE SKYLINE CENTER AMY COLE JOPLIN MO COLLEGE SKYLINE CENTER CHARLES DOYLE JOPLIN MO COLUMBIA RADIOLOGY LTD COLUMBIA MO COMPREHENSIVE CONSULTING/COUNS ROBERT FORSYTH WEST PLAINS MO COMPREHENSIVE EYE CARE LTD MICHAEL KORENFELD WASHINGTON MO COMPREHENSIVE PAIN SOLUTIONS DINA VERNER ABILENE KS COMTREA KELLEY GRAY ARNOLD MO CONCORDIA DCF OFFICE MICHAEL SCHWARTZ CONCORDIA KS COX HEALTH MEDICAL PLAZA ROBERT FORSYTH HOLLISTER MO COX MEDICAL CENTER BRANSON BRANSON MO CPC-CENTER FOR PROF COUNSELING DAVID LUTZ SPRINGFIELD MO CRANSTON CLINIC SAAD AL-SHATHIR PITTSBURG KS CRG LLC CAPE GIRARDEAU MO CRYSTAL CITY PUBLIC LIBRARY JERRY CUNNINGHAM CRYSTAL CITY MO DADE COUNTY HEALTH DEPARTMENT JAMES CARPENTER GREENFIELD MO DCF OFFICE MICHAEL SCHWARTZ HAYS KS DCFS STANLEY MINTZ WINFIELD KS DEBORAH A KING MA & ASSOC INC KEITH GRAHL KANSAS CITY MO DEBORAH A KING MA & ASSOCIATES LIBBY STARR LIBERTY MO DEBORAH KING MA & ASSOC DASCHIA CARPENTER LIBERTY MO DEBORAH KING MA & ASSOCIATES JENNIFER BOYD KANSAS CITY MO DEBORAH KING MA & ASSOCIATES LIBBY STARR KANSAS CITY MO DEPARTMENT OF OTOLARYNGOLOGY ST LOUIS MO DEPT CHILDREN & FAMILY SERVICE STANLEY MINTZ EMPORIA KS DEPT CHILDREN & FAMILY SERVICE JASON NEUFELD LAWRENCE KS DEPT CHLD & FAMILY SVCS STANLEY MINTZ S HUTCHINSON KS DIAGNOSTIC IMAGING CENTER INDEPENDENCE MO DIAGNOSTIC IMAGING CENTERS PA KANSAS CITY MO DIAGNOSTIC IMAGING CENTERS PA KANSAS CITY MO DIAGNOSTIC IMAGING CENTERS PA LEES SUMMIT MO DISCOVER VISION CENTERS JOHN TAYLOR INDEPENDENCE MO DISCOVER VISION CENTERS JOHN TAYLOR LEE'S SUMMIT MO DO NOT USE PAUL REXROAT UNION MO E L JORDAN JR DO PC E JORDAN JR JOPLIN MO EAR NOSE & THROAT SURGICAL GRP DONALD JAMES WICHITA KS EVE MEDICAL SERVICES BARTLESVILLE OK EXAM PRO JOPLIN MO EXAM PRO LLC SPRINGFIELD MO EXAM PRO LLC KANSAS CITY MO EXECUTIVE COURT BLDG JARROD STEFFAN WICHITA KS EXECUTIVE PSYCH RESCOURES AMYKAY COLE JOPLIN MO EYE HEALTH CARE DANIEL OBERMARK SIKESTON MO EYE HEALTH CARE DANIEL OBERMARK POPLAR BLUFF MO EYE SURGEONS OF SPRINGFIELD C FAULKNER SPRINGFIELD MO EYE SURGEONS OF SPRINGFIELD JUDD MCNAUGHTON SPRINGFIELD MO EYECARE ASSOC OF OSAWATOMIE OSAWATOMIE KS FAMILY MEDICAL GROUP DAVID LIPSITZ ST PETERS MO FAMILY WALK-IN CLINIC MTN GRV CHRISTY BRAMWELL MOUNTAIN GROVE MO FARMINGTON PUBLIC LIBRARY JERRY CUNNINGHAM FARMINGTON MO FERGUSON MEDICAL GROUP JAMES CRITCHLOW SIKESTON MO FERGUSON MEDICAL GROUP JAMES CRITCHLOW DEXTER MO FERGUSON MEDICAL GROUP DAVID DAHLBECK SIKESTON MO FERGUSON MEDICAL GROUP DAVID DAHLBECK EAST PRAIRIE MO FERGUSON MEDICAL GROUP DAVID DAHLBECK DEXTER MO FERGUSON MEDICAL GROUP DAVID DAHLBECK KENNETT MO FERGUSON MEDICAL GROUP MARGARET DICUS CHARLESTON MO FERGUSON MEDICAL GROUP LAUREN HARDY SIKESTON MO FERGUSON MEDICAL GROUP DAVID LAWRENCE CHARLESTON MO FERGUSON MEDICAL GROUP CINDY NAZARIO-MATOS SIKESTON MO FERGUSON MEDICAL GROUP DANA REEDER FARMINGTON MO FERGUSON MEDICAL GROUP DANA REEDER DEXTER MO FERGUSON MEDICAL GROUP AMY SHELTON SIKESTON MO FERGUSON MEDICAL GROUP MIRANDA THURMAN EAST PRAIRIE MO FERRELL DUNCAN AUDIOLOGY SPRINGFIELD MO FERRELL DUNCAN ENT ANTHONY BENTLEY SPRINGFIELD MO FERRELL DUNCAN ENT DAN CROZIER SPRINGFIELD MO FERRELL DUNCAN ENT DAVID RANDALL SPRINGFIELD MO FERRELL DUNCAN ENT JACOB SMITH SPRINGFIELD MO FHSU HERNDON CLINIC HAYS KS FIRST CHOICE PHYSICAL THERAPY BRYAN ALBRIGHT HANNIBAL MO FITZGIBBON HOSPITAL MARSHALL MO FITZGIBBON HOSPITAL RAVINDER ARORA MARSHALL MO FORT HAYS STATE UNIV STEVEN WALTERS HAYS KS FOSTER FAMILY MEDICINE & ASSOC RANDY FOSTER MOBERLY MO FREEMAN HEALTH SYSTEM NEOSHO NEOSHO MO FREEMAN HEARING CENTER DAVID ANTHONY JOPLIN MO FREEMAN HOSPITAL & HLTH SYSTEM JOPLIN MO FREEMAN HOSPITAL-PULMONARY JOPLIN MO FREEMAN OAK HILL HLTH SYSTEM JOPLIN MO (b) (6) FULTON MEDICAL CENTER FULTON MO GARDEN CITY DCF OFFICE MICHAEL SCHWARTZ GARDEN CITY KS GOLDEN VALLEY MEDICAL CLINTON CLINTON MO GOLDEN VALLEY MEMORIAL HOSP CLINTON MO GOLDEN VALLEY MEMORIAL HOSP CLINTON MO GOOD SAMARITAN REG HEALTH CARE MT VERNON IL GOODLAND REGIONAL MED CENTER GOODLAND KS HAMPTON INN BRYCE GRAY CLINTON MO HANNIBAL CLINIC RESPIRATORY HANNIBAL MO HANNIBAL CLINIC ULTRASOUND HANNIBAL MO HANNIBAL REGIONAL HOSPITAL HANNIBAL MO HANNIBAL REGIONAL HOSPITAL HANNIBAL MO HANNIBAL REGIONAL HOSPITAL HANNIBAL MO HANNIBAL REGIONAL MED GROUP LINDA CARLETON HANNIBAL MO HANNIBAL REGIONAL MED GROUP GREGORY HENRY HANNIBAL MO HARRISON COUNTY COMMUNITY HOSP BETHANY MO HAYS MEDICAL CENTER HAYS KS HAYS MEDICAL CENTER HAYS KS HEALTHPOINT MATTHEW KARSHNER CAPE GIRARDEAU MO HEAR USA (TIMBRE) COLUMBIA MO HEARTLAND CLINICAL CONSULTANTS STANLEY MINTZ TOPEKA KS HEARTLAND CTR FOR PROF COUNSEL DEBRA RAU SIKESTON MO HEDRICK MEDICAL CENTER CHILLICOTHE MO HEDRICK MEDICAL CENTER CHILLICOTHE MO HERITAGE MENTAL HEALTH CLINIC MELVIN BERG TOPEKA KS HERNDON A SNIDER & ASSOCIATES JAN KENT JOPLIN MO HOMETOWN MEDICAL BRANDON FORESTER PIERCE CITY MO INDEPENDENT IMAGING LLC JEFFREY SHORE JOPLIN MO INTERNATIONAL EYE CARE TERRENCE HAWKINS KIRKSVILLE MO IRVING ELEMENTARY LUANN BUDDING JOPLIN MO JARED NEUROSCIENCE CENTER TED LENNARD SPRINGFIELD MO JARED NEUROSCIENCE CENTER JEFFREY WOODWARD SPRINGFIELD MO JCMG STEVE LINSENBARDT JEFFERSON CITY MO JEFFERSON CITY MEDICAL GROUP THOMAS SCHNEIDER JEFFERSON CITYMO JENNINGS MEDICAL CENTER INC AQEEB AHMAD JENNINGS MO JONES EYE CENTER ROBERT JONES WEST PLAINS MO JOURNEY COUNSELING CENTER JOHN BRANDT LEBANON MO JOURNEY COUNSELING CENTER RICHARD FREDERICK LEBANON MO KANSAS IMAGING CONSULTANTS WICHITA KS KANSAS MEDICAL ASSOCIATES SITHA MILLER WICHITA KS KANSAS MEDICAL ASSOCIATES SITHA MILLER ANDOVER KS KANSAS UNIV MED CENTER ENT KANSAS CITY KS KANSAS UNIVERSITY MEDICAL CTR KANSAS CITY KS KANSAS UNIVERSITY MEDICAL CTR KANSAS CITY KS KELSEY NORMAN ELEMENTARY BETHANY BANDY JOPLIN MO KEOUGH & ASSOCIATES JOHN KEOUGH CHILLICOTHE MO KEOUGH & ASSOCIATES PSYCH JOHN KEOUGH SEDALIA MO KEOUGH & ASSOCIATES PSYCH JOHN KEOUGH KANSAS CITY MO KIRKSVILLE ALLERGY & ASTHMA KIRKSVILLE MO KNEIBERT CLINIC PFT LAB POPLAR BLUFF MO KOENEMAN PSYCHOLOGICAL SERVICE SCOTT KOENEMAN OLATHE KS KRESIE & PENZLER MDS PA RANDALL KRESIE TOPEKA KS KRESIE & PENZLER MDS PA CINDY PENZLER MD TOPEKA KS LABETTE COUNTY MEDICAL CENTER PARSONS KS LAKE OZARK RADIOLOGY INC OSAGE BEACH MO LAKE OZARKS CHIROPRACTIC CNTR ROBERT MILEY CAMDENTON MO LAKE REGIONAL HEALTH SYSTEM OSAGE BEACH MO LAKES REGION IMAGING OKLAHOMA CITY OK LAMONDA CLINIC GARY LAMONDA COLUMBIA MO LASSEN VISION CENTER RAY LASSEN DONIPHAN MO LAWRENCE MEMORIAL HOSPITAL LAWRENCE KS LAWRENCE MEMORIAL HOSPITAL LAWRENCE KS LEET EYECARE CAPE GIRARDEAU MO LIBERAL DCF OFFICE MICHAEL SCHWARTZ LIBERAL KS LIBERTY COUNSELING SERVICES JOSEPH BLEIER LIBERTY MO LIBERTY HOSPITAL LIBERTY MO LIBERTY OFFICE PARK JERRY CUNNINGHAM FARMINGTON MO LIBERTY OFFICE PARK LAURA TISHEY FARMINGTON MO LIBERTY OFFICE PARK LAURETTA WALKER FARMINGTON MO LIFESONG FOR GROWTH & WELLNESS RICHARD LILLARD JEFFERSON CITY MO LITTLE BEAR RADIOLOGY COLUMBIA MO LOWRY & ASSOCIATES DAVID BREMER MONETT MO LOWRY & ASSOCIATES LLC BRYCE GRAY MONETT MO M D ELECTRODIAGNOSIS INC JOHN SAND KANSAS CITY MO MAGNOLIA MEDICAL SERVICES SPRINGFIELD MO MAGNOLIA MEDICAL SERVICES NEVADA MO MAGNOLIA MEDICAL SERVICES LINN CREEK MO MARSHFIELD REHAB MARSHFIELD MO MARSTON HEARING CENTER LAWRENCE KS (b) (6) MATTAX NEU PRATER EYE CENTER MICHAEL ENGLEMAN SPRINGFIELD MO MATTAX NEU PRATER EYE CENTER MATTHEW SMITH SPRINGFIELD MO MATTAX NEU PRATER EYE CENTER MATTHEW SMITH MONETT MO MATTAX NEU PRATER EYE CTR INC KENNETH NEU SPRINGFIELD MO MATTAX NUE PRATER EYE CENTER MARLA SMITH LEBANON MO MCINTIRE EAR NOSE & THROAT CTR LARRY MCINTIRE JOPLIN MO MCS INCORPORATED OF MISSOURI ANTHONY MORRISON CHILLICOTHE MO MED EXAM PLUS LLC ROBERT MILEY SEDALIA MO MEDEX ST LOUIS MO MEDICAL IMAGING ASSO OF MEXICO MEXICO MO MEDPLUS BRANSON MO MEDPLUS WARRENSBURG MO MEDPLUS JOPLIN MO MEDPLUS MONETT MO MEDPLUS KIRKSVILLE MO MEDPLUS SPRINGFIELD MO MEFFORD, VAUGNIAUX, & ASSOC TOM MEFFORD SEDALIA MO MEFFORD, VUAGNIAUX & ASSOC PC TIM VUAGNIAUX LAURIE MO MEFFORD, VUAGNIAUX & ASSOC PC TIM VUAGNIAUX SEDALIA MO MEMORIAL HOSPITAL ABILENE KS MEMORIAL HOSPITAL ABILENE KS MENTAL WELLNESS LLC KAREN MACDONALD OSAGE BEACH MO MENTAL WELLNESS LLC JENNIFER STEVENS OSAGE BEACH MO MERCY CLINIC SPRINGFIELD MO MERCY CLINIC AUDIOLOGY/ENT SPRINGFIELD MO MERCY CLINIC CARDIOLOGY SPRINGFIELD MO MERCY CLINIC ORTHOPEDIC SANDRA TATE ST LOUIS MO MERCY FAMILY PRACTICE SANDRA DEMPSEY ST JAMES MO MERCY HOSPITAL AURORA AURORA MO MERCY HOSPITAL JEFFERSON FESTUS MO MERCY HOSPITAL LEBANON LEBANON MO MERCY HOSPITAL SPRINGFIELD SPRINGFIELD MO MERCY HOSPITAL WASHINGTON WASHINGTON MO MERCY HOSPITAL WASHINGTON WASHINGTON MO MERCY HOSPITAL WASHINGTON WASHINGTON MO MERCY HOSPITAL-CASSVILLE CASSVILLE MO MERCY MCCUNE-BROOKS HOSPITAL CARTHAGE MO MERCY ST FRANCIS HOSPITAL MOUNTAIN VIEW MO MERCY ST FRANCIS HOSPITAL MOUNTAIN VIEW MO MIAMI COUNTY MED CTR-RADIOLOGY PAOLA KS MID AMERICA RADIOLOGY SC ST LOUIS MO MIDWEST ASSESS & PSYCHOTHERAPY TROY MO MIDWEST ASSESS & PSYCHOTHERAPY NIXA MO MIDWEST ASSESS & PSYCHOTHERAPY BRANSON MO MIDWEST ASSESS & PSYCHOTHERAPY SPRINGFIELD MO MIDWEST ASSESS & PSYCHOTHERAPY SPRINGFIELD MO MIDWEST ASSESS & PSYCHOTHERAPY MONETT MO MIDWEST BONE & JOINT PC NOLA MOORE MACON MO MIDWEST CES N KANSAS CITY MO MIDWEST CES KANSAS CITY MO MIDWEST CES ST JOSEPH MO MIDWEST CES ROLLA MO MIDWEST CES WEST PLAINS MO MIDWEST CES CAPE GIRARDEAU MO MIDWEST CES COLUMBIA MO MIDWEST CES SEDALIA MO MIDWEST CES BOLIVAR MO MIDWEST CES CHILLICOTHE MO MIDWEST CES JEFFERSON CITY MO MIDWEST CES MACON MO MIDWEST CES ST LOUIS MO MIDWEST CES HANNIBAL MO MIDWEST CES JOPLIN MO MIDWEST CES CHANUTE KS MIDWEST CES KANSAS CITY MO MIDWEST CES TROY MO MIDWEST CHEST CONSULTANTS THOMAS SILER ST CHARLES MO MIDWEST RADIOLOGICAL ASSOC ST LOUIS MO MIDWEST REHABILITATION PA JAY JANI TOPEKA KS MISSOURI EAR NOSE & THROAT CTR COLUMBIA MO MISSOURI OCCUPATIONAL INJURY KEVIN KOMES COLUMBIA MO MISSOURI OCCUPATIONAL MEDICINE BOBBY ENKVETCHAKUL WASHINGTONMO MISSOURI VALLEY PHYSICIANS JACK UHRIG MARSHALL MO MO DELTA MEDICAL CENTER SIKESTON MO MOBERLY REGIONAL MEDICAL CTR MOBERLY MO MORE THAN THERAPY LETISHAE DAVIS ST LOUIS MO MOSAIC LIFE CARE AT ST JOSEPH ST JOSEPH MO MOSAIC LIFE CARE BURLINGTON KANSAS CITY MO MOSAIC LIFE CARE COUNSELING TOM BEIN ST JOSEPH MO (b) (6) MOSAIC LIFE CARE COUNSELING TOM BEIN ST JOSEPH MO MOSAIC LIFE CARE COUNSELING RICHARD TAYLOR ST JOSEPH MO MOSAIC LIFE CARE COUNSELING RICHARD TAYLOR ST JOSEPH MO MOSAIC LIFE CARE OF ST JOSEPH ST JOSEPH MO MOSAIC LIFE CARE PULM & CRIT ST JOSEPH MO MOSAIC LIFE CARE SHOAL CREEK KANSAS CITY MO MURPHY WATSON BURR EYE CENTER WILLIAM BURR ST JOSEPH MO MURPHY WATSON BURR EYE CENTER SCOTT MURPHY ST JOSEPH MO MURPHY WATSON BURR EYE CENTER SCOTT MURPHY CHILLICOTHE MO MURPHY WATSON BURR EYE CENTER R WATSON ST JOSEPH MO NASM DANIEL KAN SPRINGFIELD MO NEUROLOGIC ASSOCIATES OF CAPE ROBERT GARDNER JR CAPE GIRARDEAU MO NEUROPSYCHOLOGICAL ASSOC SW MO MOUNTAIN GROVE MO NEVADA REGIONAL MEDICAL CENTER NEVADA MO NORTHEAST MO IMAGING ASSOC HANNIBAL MO NORTHEAST REGIONAL MEDICAL CTR KIRKSVILLE MO NU CARE POPLAR BLUFF MO NU CARE KENNETT MO NU CARE FARMINGTON MO OACAC BRYCE GRAY BOLIVAR MO OCCUPATIONAL MEDICINE CLINIC J PAULINE ABBOTT OSAGE BEACH MO OLATHE MEDICAL CENTER OLATHE KS ONSITE REHABILITATION PC GEOFFREY CARSON OSAGE BEACH MO ORTHO ONE INC BLUE SPRINGS MO ORTHOPAEDIC SPORTS HEALTH MICHAEL JOHNSON SALINA KS OSAGE BEACH LIBRARY BRYCE GRAY OSAGE BEACH MO OZARK OB/GYN AMBER RICHARDSON POPLAR BLUFF MO OZARK PHYSICAL THERAPY POPLAR BLUFF MO OZARK PSYCHOLOGICAL ASSOCIATES SARA HOLLIS SPRINGFIELD MO OZARKS FAMILY VISION CENTRE STEPHEN PIERSON BRANSON MO OZARKS MEDICAL CENTER WEST PLAINS MO PARKLAND HEALTH CENTER FARMINGTON MO PARTNERS IN REHAB MEDICINE STEVEN HENDLER KANSAS CITY MO PATHWAYS MICHAELA BEEZLEY ROLLA MO PATHWAYS MICHAELA BEEZLEY SULLIVAN MO PATHWAYS CATHY GRIGG LEBANON MO PATHWAYS TOSHA LARSON RAYMORE MO PATHWAYS JONATHAN ROSENBOOM WARRENSBURG MO PATHWAYS JONATHAN ROSENBOOM SEDALIA MO PATHWAYS SARA WILSON LEBANON MO PATHWAYS COMM BEHAV HLTHCARE ASHLEY PARKS CLINTON MO PATHWAYS-HARBOR VILLAGE JONATHAN ROSENBOOM WARSAW MO PCRMC-BOND CLINIC LARRY MAZZEO ROLLA MO PEAK SPORT & SPINE GREGGORY KUHLMANN OSAGE BEACH MO PEAK SPORT & SPINE GREGGORY KUHLMANN SEDALIA MO PEAK SPORT & SPINE GREGGORY KUHLMANN MOBERLY MO PEAK SPORT AND SPINE PT JESSICA CHANEY OSAGE BEACH MO PEDIATRIC THERAPY SERVICES HANNIBAL MO PHELPS CO REGIONAL MEDICAL CTR ROLLA MO PHELPS CO REGIONAL MEDICAL CTR ROLLA MO PHYSICAL THERAPY SPECIALIST BRYCE GRAY MOUNTAIN GROVE MO PHYSICAL THERAPY SPECIALISTS ALISE GRAY MOUNTAIN GROVE MO PHYSICIANS PARK PRIMARY CARE POPLAR BLUFF MO PIKE CO MEMORIAL HOSPITAL LOUISIANA MO PLAINS RADIOLOGY SERVICES KEARNEY NE POLLOCK PSYCHOLOGICAL SERVICES ANN POLLOCK JEFFERSON CITY MO POPLAR BLUFF NEUROLOGY CTR PC SHAHID CHOUDHARY POPLAR BLUFF MO POTOSI RURAL HEALTH PATTY ALLEN POTOSI MO PRATT DCF OFFICE MICHAEL SCHWARTZ PRATT KS PRECISION EYE CARE JOHN FITZ FARMINGTON MO PREMIER HEALTH CENTER YASUO ISHIDA SULLIVAN MO PRO OF KENNETT REHAB SERVICES KEN RUBENACKER KENNETT MO PROVIDENCE MEDICAL CENTER KANSAS CITY KS PROVIDENCE MEDICAL CENTER KANSAS CITY KS PSYCHOLOGICAL ASSOCIATES THEODORE MOELLER WICHITA KS PSYCHOLOGISTS & EDUCATORS INC ALAN POLITTE ST LOUIS MO PSYCHOLOGY ASSOCIATES INC FRANK FROMAN QUINCY IL PUTNAM COUNTY MEMORIAL HOSP UNIONVILLE MO QMB RADIOLOGY LLC SPRINGFIELD MO RADIOLOGIC IMAGING CONSULTANTS ST CHARLES MO RADIOLOGIC PROFESSIONAL SERV LAWRENCE KS RADIOLOGY & NUCLEAR MEDICINE TOPEKA KS RADIOLOGY ASSOCIATES OF HAYS KANSAS CITY MO RADIOLOGY CONSULTANTS COLUMBIA MO RADIOLOGY IMAGING ASSOCIATES ENGLEWOOD CO RADIOLOGY SPEC OF ST JOSEPH PC ST JOSEPH MO RAMULA SAMUDRALA MD RAMULU SAMUDRALA ST LOUIS MO RAMULU SAMUDRALA MD PC RAMULU SAMUDRALA ST LOUIS MO RANSOM MEMORIAL HOSPITAL OTTAWA KS (b) (6) RAPID RADIOLOGY INC LAKEWAY TX RDI BUILDING JOAN BENDER SPRINGFIELD MO REAM OPTOMETRY ANNE REAM WEST PLAINS MO REDLINK FESTUS MO REDLINK INC HAYS KS REDLINK INC MCCOOK NE REYNOLDS & ANLIKER MANHATTAN KS RHEUMATOLOGY SPECIALISTS OF KC CAMERON JONES KANSAS CITY MO RIVER CITY HEALTH CLINIC WANDA HORN CAPE GIRARDEAU MO RIVER PARK PSYCH CONSULTANTS MICHAEL SCHWARTZ WICHITA KS ROCKHILL PLAZA BUILDING KAT BOWIE KANSAS CITY MO ROGERSVILLE PHYSICAL THERAPY ROGERSVILLE MO RUNDE OCCUPATIONA ERV & PHY EDDIE RUNDE MEXICO MO RUNDE OCCUPATIONAL ERV & PHY EDDIE RUNDE COLUMBIA MO SAGO & STREET EYECARE LLC JASON STREET FARMINGTON MO SALEM MEMORIAL DISTRICT HOSP JOHN DEMORLIS SALEM MO SALEM MEMORIAL HOSPITAL SALEM MO SALEM MEMORIAL HOSPITAL SALEM MO SALINA REG MED ARTS IMAGING SALINA KS SALINA REGIONAL HEALTH CENTER SALINA KS SALINA REGIONAL MEDICAL ARTS SALINA KS SALVATION ARMY PAUL REXROAT CAPE GIRARDEAU MO SAMARITAN MEMORIAL HOSPITAL MACON MO SBS MEDICAL SERVICES INC STEPHEN SMITH ST LOUIS MO SCHULTZ PSYCHOLOGICAL SERVICES LINDA SCHULTZ JEFFERSON CITY MO SCOTLAND COUNTY MEMORIAL HOSP MEMPHIS MO SCOTT COUNTY CENTRAL ELEM SCHL LANA ATKINS SIKESTON MO SCOTT RADIOLOGY GROUP ST LOUIS MO SEE REMARKS DAVID SIMCKES ST PETERS MO SEMO COMMUNITY SERVICES JERRY CUNNINGHAM KENNETT MO SEMO HEALTH NETWORK DAVID DAHLBECK KENNETT MO SHADOW WOOD CLINICAL ASSOCIATE THOMAS BARTLETT TOPEKA KS SHEEHAN PSYCHOLOGICAL SERVICES TAMMY SHEEHAN KANSAS CITY MO SHOP #1 STANLEY MINTZ CHANUTE KS SMITH IMAGING INC PEORIA IL SMITH STREET CLINIC ADONIS BERNARDO SIKESTON MO SOMERS EYE CENTER MICHAEL SOMERS KANSAS CITY MO SOUTH CENTRAL KS REG MED CTR ARKANSAS CITY KS SOUTH CITY HEARING & AUDIOLOGY NANCY RICHMAN ST LOUIS MO SOUTHEAST HEALTH MALDEN CLINIC KIMBERLY ESSNER MALDEN MO SOUTHEAST HEALTH STODDARD CTY DEXTER MO SOUTHEAST HLTH CTR-RIPLEY CTY DONIPHAN MO SOUTHERN MEDICAL GROUP WICHITA KS SOUTHERN MEDICAL GROUP TOPEKA KS SOUTHERN MEDICAL GROUP SALINA KS SOUTHERN MEDICAL GROUP KANSAS CITY KS SOUTHERN MEDICAL GROUP DODGE CITY KS SOUTHERN MEDICAL GROUP LAWRENCE KS SOUTHSIDE CENTER SAAD AL-SHATHIR JOPLIN MO SOUTHWEST MEDICAL CENTER LIBERAL KS SOUTHWEST MISSOURI EXAMS JOPLIN MO SOUTHWEST PLAZA OFFICE BLDG JASON NEUFELD TOPEKA KS SOUTHWEST REHABILITATION BRANSON WEST MO SPECIALISTS IN INTERNAL MED MELVIN BUTLER CLAYTON MO SPEECH LANGUAGE SERVICES ROBIN RICKMAN DEXTER MO SSM HLTH-ST JOSEPH WENTZVILLE WENTZVILLE MO ST ALEXIUS HOSPITAL ST LOUIS MO ST FRANCIS FAMILY HEALTH CARE KANTI HAVALDAR MARYVILLE MO ST FRANCIS HEALTHCARE TOPEKA KS ST FRANCIS HEALTHCARE TOPEKA KS ST FRANCIS HEALTHCARE TOPEKA KS ST FRANCIS HOSPITAL MARYVILLE MO ST FRANCIS MED CTR/HEALING ART LORELEI LEIBLE CAPE GIRARDEAUMO ST FRANCIS MEDICAL CENTER CAPE GIRARDEAU MO ST FRANCIS MEDICAL CENTER STEPHEN JORDAN CAPE GIRARDEAU MO ST LOUIS PSYCH SERVICES CLAYTON MO ST LUKES MIDWEST PULMONARY CON KANSAS CITY MO ST LUKES REGION LAB KANSAS CITY MO ST MARYS HOSPITAL-AUDRAIN MEXICO MO ST ROSE HEALTH CENTER GREAT BEND KS STONEY CREEK HOTEL & CONF CTR BRYCE GRAY ST JOSEPH MO STONEY CREEK HOTEL & CONF CTR ALISE GRAY ST JOSEPH MO STORMONT-VAIL HEALTHCARE TOPEKA KS STORMONT-VAIL HEALTHCARE TOPEKA KS T.P. CHILDREN & TEENS CARE TASANAPORN PITIYANUVATH KANSAS CITY MO TENNEY PEDIATRIC & ADOLESCENT DIONNE COZIER ROSS KANSAS CITYMO TENNEY PEDIATRIC & ADOLESCENT PAOLA LUNA KANSAS CITY MO TENNEY PEDIATRIC & ADOLESCENT JACKIE TENNEY KANSAS CITY MO TEXAS COUNTY MEMORIAL HOSPITAL HOUSTON MO (b) (6) THE HEADACHE & PAIN CENTER PA BERNARD ABRAMS LEAWOOD KS THE LUNG CENTER ST LOUIS MO THERACARE OUTPATIENT SERVICES MELANIE STINNETT SPRINGFIELD MO THERAPY ASSOCIATES OF OZARKS LEBANON MO THERAPY ASSOCS OF THE OZARKS SPRINGFIELD MO THERAPY ASSOCS OF THE OZARKS DEBRA LEWIS SPRINGFIELD MO TLC PEDIATRICS PC ASSAD SHAFFIEY SEDALIA MO TO YOUR HEALTH FAM MED CLINIC CAROLLE SILNEY COLUMBIA MO TRI STATE OCCUPATIONAL MED BARRY BURCHETT FARMINGTON MO TRI STATE OCCUPATIONAL MED BARRY BURCHETT SIKESTON MO TRI STATE OCCUPATIONAL MED BARRY BURCHETT KENNETT MO TRI STATE OCCUPATIONAL MED RAYMOND LEUNG WASHINGTON MO TRI-STATE OCCUPATIONAL MEDICIN BARRY BURCHETT PEVELY MO TWIN RIVERS REGIONAL MEDICAL KENNETT MO UNITED IMAGING CONSULTANTS LLC MISSION KS UNITED METHODIST CHURCH KENNETH SHERRY HUMANSVILLE MO UNITED RADIOLOGY BILLING SALINA KS US HEALTHCARE SHOAL CREEK KANSAS CITY MO US HEALTHWORKS ST JOSEPH MO US HEALTHWORKS KANSAS CITY MO US HEALTHWORKS MED GROUP OF KC DARYL THOMAS KANSAS CITY MO USA RADIOLOGY MANAGEMENT ST LOUIS MO VIA CHRISTI HOSPITAL PITTSBURG PITTSBURG KS VIA CHRISTI ST FRANCIS HOSP WICHITA KS VICTORY MINISTRY ROBERT MCDERMID JOPLIN MO VICTORY MINISTRY GYM KEVIN WHISMAN JOPLIN MO VILLAGE PLAZA JASON WELLS ATCHISON KS VISION CLINIC BRANSON BRANSON MO WARREN CO SCENIC REG LIBRARY BRYCE GRAY WARRENTON MO WARRENSBURG INTERNAL MEDICINE JAYENDRA ASTIK WARRENSBURG MO WASHINGTON UNIV VASCULAR LAB BRIAN RUBIN ST LOUIS MO WEBER SPEECH CLINIC REBECCA WEBER ST JOSEPH MO WEST COUNTY RADIOLOGICAL GROUP ST LOUIS MO WEST PARK MEDICAL CLINIC RAYMOND LEUNG QUINCY IL WEST PARK MEDICAL CLINIC RAYMOND LEUNG ALTON IL WESTERN MISSOURI INTERNAL MED SYED HASAN WARRENSBURG MO WESTERN MO MEDICAL CENTER WARRENSBURG MO WESTWOOD MEDICAL CLINIC INC CHUL KIM POPLAR BLUFF MO WICHITA OPTHALMOLOGY SAM COHLMIA WICHITA KS WICHITA RADIOLOGICAL GROUP PA OKLAHOMA CITY OK WINDSOR MEDICAL GROUP CALEB MASTERSON NIXA MO WSU SPEECH LANGUAGE HEARING WICHITA KS ZAINALI A MD RADIOLOGY PA WICHITA KS PAID AMOUNT VENDOR/REMIT VENDOR VENDOR REMIT CITY D

$249,996.84 TRI-STATE OCCUPATIONAL Total BARRY BURCHETT, MD HUNTINGTON S83 $104,407.94 CUNNINGHAM, JERRY Total MALDEN S83 $95,254.27 FERGUSON MEDICAL GROUP RURAL & LP Total (DAVID DAHLBECK, PHD) SIKESTON S83 $84,145.14 WESTWOOD MEDICAL CLINIC INC Total CHUL KIM, MD POPLAR BLUFF S83 $36,196.81 SOUTHEAST MISSOURI HOSPITAL Total MATTHEW KARSHNER, MD CAPE GIRARDEAU S83 $32,506.63 WALKER, LAURETTA V Total IRONTON S83 $10,021.34 GRAY, KELLEY Total FARMINGTON S83

$160,233.37 ASSOCIATED BEHAVIORAL Total TOM SPENCER, PHD FULTON S80 $71,213.64 COMPASS HEALTH INC Total PATHWAYS CLINTON S80 $40,269.10 SCHMITZ, MARK W Total COLUMBIA S80 $30,366.63 SCHULTZ, LINDA L Total COLUMBIA S80 $20,584.48 POLLOCK PSYCIOLOGICAL SERVICES Total ANN POLLOCK, PSYD JEFFERSON CITY S80

$742,361.48 MIDWEST CES Total NORTH SALT LAKE S82 $95,492.33 ISRAEL, ALAN R Total SHAWNEE MISSION S82 $84,404.53 KEOUGH, JOHN A Total BUTLER S82 $73,207.72 RICK D THOMAS PHD LLC Total BELTON S82 $60,230.13 MICHAEL H SCHWARTZ PHD PC Total OVERLAND PARK S82 $35,306.90 LIEBERMAN, LYNN I Total WESTWOOD HILLS S82 $22,102.54 ASSESSMENT CONSULTANTS LLC Total AMY M FISCH, PHD SPRINGFIELD S82

$179,756.38 GRAY PSYCHOLOGICAL SERVICES Total ALICE GRAY, PSYD & BRYCE GRAY, PSYD NIXA S84 $139,493.25 EXAM PRO LLC Total SPRINGFIELD S84 $104,192.81 MEDPLUS DISABILITY EDUCATIONS Total FRANKLIN, TN S84 $77,657.26 MIDWEST ASSESSMENT AND PSYCHOTHERAPY (MAPS) Total SPRINGFIELD S84 $71,574.11 FORSYTH, ROBERT Total SPRINGFIELD S84 $35,324.80 KAN, DANIEL Total AURORA S84 $8,591.28 ANDERSON, FRANCES J Total TURNERS S84

$922,991.73 FOREST PARK MEDICAL CLINIC INC Total MEDEX ST LOUIS S81 $111,481.06 PAUL W REXROAT PHD PC Total PACIFIC S81 $106,498.83 ST LOUIS PYSCHOLOGICAL SERVICE Total ALISON BURNER, PHD WILDWOOD S81 $81,726.10 LAURA R TISHEY PSY D LLC Total CLAYTON S81 $69,550.07 MICHAEL T ARMOUR PHD LLC Total CLAYTON S81 $67,108.41 LEONBERGER, F TIMOTHY Total ST LOUIS S81 DDS OFFICE ONSITE Key Provider Top 5, $150,000+ or Primarily CE Work

Cape Girardeau Yes Yes Top 5 and $150,000+ Cape Girardeau Yes Cape Girardeau Yes Cape Girardeau Yes Cape Girardeau Yes Cape Girardeau Yes Yes Primarily CE Work Cape Girardeau Yes Yes Primarily CE Work

Jefferson City Yes Yes Top 5 and $150,000+ Jefferson City Yes Jefferson City Yes Yes Primarily CE Work Jefferson City Yes Yes Primarily CE Work Jefferson City Yes

Kansas City Yes Yes Top 5 and $150,000+ Kansas City Yes Yes Primarily CE Work Kansas City Yes Yes Primarily CE Work Kansas City Yes Yes Primarily CE Work Kansas City Yes Yes Primarily CE Work Kansas City Yes Yes Primarily CE Work Kansas City Yes Yes Primarily CE Work

Springfield Yes Yes Top 5 and $150,000+ Springfield Yes Yes Primarily CE Work Springfield Yes Yes Primarily CE Work Springfield Yes Yes Primarily CE Work Springfield Yes Springfield Yes Yes Primarily CE Work Springfield Yes Yes Primarily CE Work

St Louis Yes Yes Top 5 and $150,000+ St Louis Yes Yes Primarily CE Work St Louis Yes Yes Primarily CE Work St Louis Yes Yes Primarily CE Work St Louis Yes Yes Primarily CE Work St Louis Yes Yes Primarily CE Work CE providers removed due to inactive license, sanction or removal for cause with reason noted:

Not applicable Mississippi FY 2017

CE COST SORTED BY TOTALS report 10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 1

Total Cost Key Name Vendor No. 526,952.00 C. E. PROVIDER SERVICES 303,008.14 MDSI PHYSICIAN GROUP INC (b) (6) 247,537.00 WHELAN, WILLIAM MICHAEL 227,241.00 ALEXANDER, J MORRIS 221,171.00 BOGGS, JAN 204,880.00 ZAKARAS, PATSY H 184,265.00 LOTT, W. CRISS 170,900.64 RIDGELAND DIAGNOSTIC CENTER 124,972.00 PROFESSIONAL ASSESSMENT CTR 121,978.00 RC SSD LLC 114,649.00 MIDWAY FAMILY CARE 98,168.00 ADAMS, JAMES GRAY 87,983.00 DRUMHELLER PSYCHOLOGICAL SR 86,412.00 MED PLUS DISABILITY EVALUAT 78,581.00 BLAYLOCK MED CL 77,586.00 GAMMEL COMPANIES 74,959.00 ZAKARAS, MICHAEL E. 74,430.00 COLUMBIA PSYCHOLOGIVAL SERV 67,452.38 SIEGEL, BARRY ROSS 62,469.00 SAVELL, HAROLD E. 61,803.00 MASUR, LOUIS III 59,635.00 LANE, JAMES R. III 53,534.00 THOMAS, WILLIAM BRIAN 52,354.00 REG 1 MENTAL HEALTH CENT 51,248.00 SMITH, GEORGE 50,282.47 RANDOLPH, BRUCE W MD 47,574.00 TRI STATE OCCUPATIONAL MED 39,555.00 SISON, GUSTAVE F JR 38,881.00 BARRILLEAUX, GERALD STEVE 38,530.13 ENVISION EYE CARE INC 38,358.00 YAZDANI, LISA B PHD 36,321.25 TUNICA CO HEALTHCARE AUTHOR 33,806.46 SINGING RIVER HOSPITAL 33,583.00 MYERS, BARBARA P 33,246.87 JEFF ANDERSON REG MED CTR 32,766.66 EXPRESS CARE WEST 27,529.00 SOUTHERN MEDICAL GROUP INC 26,686.00 JENKINS, GEORGINA F MS 26,040.00 LEONARD, PAUL S 25,871.00 HETRICK, ETHEL W PHD 23,681.82 GOLDEN TRIANGLE REG MED CTR 23,557.00 MATHERNE, J DONALD 23,330.00 BETTER COMMUNICATION CLINIC 23,150.24 MERIT HEALTH -CENTRAL 23,021.93 SOUTH CENTRAL REG MEDICAL C 22,803.00 LINDSEY, MICHAEL SLP 22,068.58 FORREST GENERAL HOSPITAL CECOSTTOT CECOSTTOTR/JGMLIB 10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 2

Total Cost Key Name Vendor No. 21,819.67 DELTA REGIONAL MEDICAL CENT 20,957.00 TATUM, ROBERT E 20,772.00 MOYE, JEFF INC (b) (6) 19,912.00 DRS CRAIN AND MORRIS 19,678.00 MARION COUNSELING SERVICES 19,333.89 SW MS REGIONAL MEDICAL CENT 17,950.00 TRICOUNTY PULMONARY & SLEEP 17,860.29 GREEN EYE INSTITUTE, PA 17,691.58 UMMC GRENADA 17,589.50 MEMORIAL HOSP AT GULFPORT 16,958.25 MAGNOLIA REGIONAL HEALTH CT 16,938.00 EICKE, FRANCIS J. 16,827.94 EYE CLINIC 16,249.00 RABY, JOANN P 15,876.00 CLARKSDALE SPEECH JENNIE 15,756.02 GREENWOOD LEFLORE HOSPITAL 15,676.00 JACKSON, HELEN PSYD 15,568.00 POWERS, DAVID D 15,037.69 CARDIOLOGY ASSOC OF N MS PA 14,934.00 STOUDENMIRE, JOHN JR 14,822.00 SPEECH PATHOLOGY ASSOC INC 14,295.00 PROFESSINAL PSYCHOLOGY SERV 14,218.62 MERIT HEALTH-NATCHEZ 13,987.00 JACKSON CARDIOLOGY ASSOC 13,655.00 ENT & FACIAL PLASTIC SURGER 13,478.34 OSBORNE, YVONNE H 13,378.21 SINGING RIVER RADIOLOGY GRO 12,980.00 EAR NOSE & THROAT PHY OF N 12,411.75 DRS COOPER AND PANG 11,417.57 ORTHOPAEDIC CLINICS OF SW M 11,364.50 BRASWELL, T KEVIN 11,078.73 MERIT HEALTH NW REG MED CTR 10,371.49 JACKSON RADIOLOGY ASSOCIATE 10,075.00 WASHINGTON, LINDA M PHD 9,158.62 GREENVILLE CLINIC 9,094.00 NEVELS, ROBERT MOUNGER 8,787.00 BURKE, RANDY S 8,671.29 MERIDIAN IMAGING PA 8,485.72 GOLDEN TRIANGLE RADIOLOGY P 8,402.47 ASSAF, MOHAMMAD 8,072.00 BROWN, JAMES S III 7,885.33 BARNES CROSSING VISION CENT 7,869.00 REMEDIAL SPECIALIST INC 7,804.09 KING'S DAUGHTERS MEDICAL CT 7,468.00 AUSTIN, JAMES B. 7,280.12 EYE CLINIC OF MERIDIAN 7,044.87 NESHOBA CO GENERAL HOSPITAL CECOSTTOT CECOSTTOTR/JGMLIB 10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 3

Total Cost Key Name Vendor No. 6,707.18 RADIOLOGY ASSOC-LAUREL 6,572.00 HAAG, GEORGE J PSYD 6,297.00 MINDFUL ACCEPTANCE THERAPIE (b) (6) 6,292.55 LAKELAND RADIOLOGISTS 5,587.08 ALLIANCE HEALTHCARE SYSTEM 5,565.00 PARKER, JEFFERSON D PHD 5,393.00 FLEETWOOD, BARBARA 5,385.00 GULF COAST CHILDRENS CLINIC 5,382.87 BAPTIST MEM HOSP-NORTH MS 5,066.31 IMA OF TUPELO 4,897.00 MEDICAL FOUNDATION OF CENT 4,864.00 HAYS, TONYA F PHD 4,850.75 DESOTO 4,664.46 COPIAH COUNTY MEDICAL CTR 4,580.53 RADIOLOGY ASSOC OF OXFORD 4,568.34 COMPREHENSIVE RADIOLOGY SRV 4,404.63 MERIT HEALTH-BILOXI 4,387.04 JAGWANI, SUNDER MD 4,359.69 BOLIVAR MEDICAL CENTER 4,338.34 MAGNOLIA IMAGING ASSOCIATES 4,230.00 INTERNAL MEDICINE CLINIC 4,134.46 BRANDON 3,881.31 MERIT HEALTH 3,818.10 MERIT HEALTH RIVER REGION 3,701.00 PATTERSON, KATHLEEN SUE PHD 3,535.00 SW MS ENT CLINIC 3,486.26 SEARK RADIOLOGY PA 3,455.11 OXFORD EYE CLINCI 3,451.35 MARION GENERAL HOSPITAL 3,399.13 ST DOM JACKSON MEM HOSPITAL 3,248.00 PSYCHOLOGY ASSOCIATES 3,236.66 MERIT HEALTH 2,912.28 NELSON, HUNTER B MD 2,886.04 WINSTON MEDICAL CLINIC LLC 2,840.36 COOK, JEFFREY N 2,774.53 PREMIER RADIOLOGY PA 2,688.00 HALL, DONALD S JR 2,605.50 TUPELO EYE CLINIC 2,300.00 MISSISSIPPI BEHAVIORAL HEAL 2,270.78 RADIOLOGY ASSOC OF NATCHEZ, 2,035.23 MERIT HEALTH BATESVILLE 1,920.00 YOUNG, LASHUN PH.D 1,898.09 SMB RADIOLOGY PA 1,786.10 MS BAPTIST MEDICAL-ATTALA 1,752.88 SIMPSON GENERAL HOSPITAL 1,743.34 TRACE REGIONAL HOSPITAL 1,741.24 TYLER HOLMES MEMORIAL HOSPI CECOSTTOT CECOSTTOTR/JGMLIB

10/19/17 15:58:46 CE TOTALS 10/01/16 - 09/30/17 PAGE 4

Total Cost Key Name Vendor No. 1,658.60 MERIDIAN PEDIATRICS PLLC 1,610.86 HOGAN EYE CLINIC PA (b) (6) 1,609.82 MID-SOUTH IMAGING/THERAPEUT 1,607.75 MISSISSIPPI BAPTIST MED CTR 1,597.18 KING'S DAUGHTERS HOSPITAL 1,586.14 NEW COAST CARDIOLOGY PLLC 1,585.94 RADIOLOGICAL GROUP PA 1,520.52 BROOKHAVEN RADIOLOGY PLLC 1,461.01 HANCOCK MEDICAL CENTER 1,260.80 CASTILLO, JULIO DEL 1,131.31 ASSOCIATED RADIOLOGISTS, PA 1,117.98 PRIOR RADIOLOGY SERVICES PA 1,095.62 CROSSROADS EYE CENTER LLC 733.55 SINGING RIVER HOSPITAL 539.34 DIAGNOSTIC ULTRASOUND CONSU 536.65 FORREST GENERAL HOSPITAL 498.29 TILLMAN MEDICAL GROUP 491.89 RADIOLOGY PHYSICIANS OF NEW 455.00 HATTIESBURG CLINIC PA 436.08 RIGDON, EDWARD E 431.72 COGNITIVE BRIDGES, INC 294.00 SINGING RIVER HEALTH SYS 275.30 BADVE, SEEMA A 265.00 STARKVILLE PEDIATRIC CLINIC 252.22 ACCESS RADIOLOGY 226.50 JACKSON EYE ASSOCIATES PLLC 211.45 AMORY HMA INC/GILMORE 210.00 MERIDIAN MEDICAL ASSOCIATES 200.00 HEAD & NECK SURGICAL GROUP 170.00 GULF COAST AUDIOLOGY INC 168.25 COLEMAN EYE CENTER 156.00 EYE ASSOCIATES OF THE SOUTH 129.02 OKTIBBEHA COUNTY HOSPITAL 120.45 YALOBUSHA GENERAL HOSPITAL 120.00 SEMINARY FAMILY HEALTH CTR 105.00 DULAM, VIKRAMADITYA 101.00 BPSOS 85.00 TURNER CARE 70.00 NATCHEZ MEDICAL FOUNDATION 58.25 HALL, JAMES E MD 43.71 VIRTUAL RADIOLOGIC PROFESSI 35.00 FG 29.29 BAPTIST MEM HOSP - BOONEVIL 19.74 RPG MEDICAL OF N MS LLC 19.23 CENTRAL MS RADIOLOGY 5.00 MEDICAL FOUNDATION OF CENT .00 MEDICAL IMAGING LLC .00 THE NEUROLOGY GROUP PC

* * * E N D O F R E P O R T * * * CECOSTTOT CECOSTTOTR/JGMLIB Montana FY 2017 Onsite KEY VENDORS KEY PROVIDER Visits Provider List ALL SUMMARY TOTALS X MARK MOZER PHD-MISSOULA VIDEO 305 REDLINK 1269 X REDLINK-BILLINGS 295 MOZER 943 REDLINK-MISSOULA 278 SOPHIA 254 MARK MOZER PHD-GF VIDEO CE 250 PETERSON 194 X TRISTAN SOPHIA PSYD-BILLINGS 242 MAHONEY 163 REDLINK-GREAT FALLS 237 GREGG 152 MARK MOZER PHD-BUTTE 217 DONALDSON 137 DEAN GREGG PHD 152 REED 101 X F TOM PETERSON EDD-BILLINGS 133 NASH 96 REDLINK-BUTTE 133 MARIAS 88 REDLINK-WHITEFISH 130 X DAVID J MAHONEY PHD-WHITEFISH 102 Top5 Key Providers X THERESA M REED PHD-MISSOULA 101 No providers removed d/t license, sanction, or REDLINK-HELENA 94 other removal MARIAS HEALTHCARE CENTER 88 PAUL DONALDSON MD-BOZEMAN 84 X ALAN BAUER EDD- BILLINGS 76 DONNA M ZOOK PHD 63 X MARK MOZER PHD-HELENA 63 X DAVID J MAHONEY PHD-LIBBY 61 F TOM PETERSON EDD-MILES CITY 61 X SUSAN K DAY PHD MISSOULA 61 REDLINK-GLASGOW 54 PAUL DONALDSON MD-HELENA 53 X PROVIDENCE ST JOSEPH-IRWIN MD 49 MARK MOZER PHD-GREAT FALLS 48 MICHAEL NASH PHD-BOZEMAN 48 MARK MOZER PHD-GLASGOW VIDEO C 47 X OCCUPATIONAL HEALTH & WELLNESS 45 BIGHORN VALLEY HEALTH CENTER 44 X LIBBY CLINIC 43 REDLINK-HAVRE 42 GABERT CLINIC 40 JIM MURPHEY PHD 40 X SWEETGRASS PSYCH SVCS-WHITEFIS 40 CORY D HESSEL PHD 37 ROSEBUD HEALTHCARE CTR CLINIC 36 WALKER ASHCRAFT MD 30 LIVINGSTON HEALTHCARE-CLINIC 27 X CLANCY CONE MD 26 MICHAEL NASH PHD-LIVINGSTON 25 X ED TRONTEL PHD 20 CAPITAL CITY CONSULTANTS 18 X MONTANA EYE CARE- MISSOULA 18 X ROBERT KAUTZ OD 18 X TRACY ROGERS PAC 15 MARK MOZER PHD-DEER LODGE PRIS 13 NORTHERN MT FAMILY MED CTR 12 TRISTAN SOPHIA PSYD-LIVINGSTON 12 BAIR MEMORIAL CLINIC 11 MICHAEL NASH PHD-BILLINGS 11 MICHAEL NASH PHD-CUT BANK 11 PLENTYWOOD CLINIC 11 X VICTOR DAVIS MD 10 JENNIFER LEIGHT PHD 9 WILLIAM FERNANDEZ MD-GLASGOW 7 RUBY VALLEY RURAL HEALTH CLINI 6 MARY KAY BOGUMILL PHD-BUTTE 0 PATRICK MCGREE MD 5 TWIN BRIDGES RURAL HEALTH CLIN 5 FALLON MEDICAL CLINIC 4 REDLINK-SANDPOINT 4 X SWEETGRASS PSYCHOLOGICAL SVCS 4 X BIGFORK MEDICAL CLINIC- DR JEN 3 GREG VOLK PSYD 3 SUSAN TAYLOR SLP- HELENA 3 BILLINGS CLINIC CARDIOLOGY 2 X CHILDRENS CLINIC 2 GABERT CLINIC- WIBAUX 2 GREAT FALLS CLINIC-PEDIATRICS 2 NORTHERN MT BEHAVIORAL HEALTH 2 PEDIATRIC THERAPY CLINIC 2 REDLINK-POST FALLS 2 VIBRANT HEARING-MISSOULA 2 ALLISON FAILING SLP 1 CLINICAL PSYCH CENTER 1 CURT WHICKER MS-GLENDIVE 1 CURT WHICKER MS-MILES CITY 1 FRANCES MAHON DEAC HOSP-MALTA 1 X GLACIER EYE CLINIC 1 MARTA KING MD 1 MICHAEL NASH PHD-SHELBY 1 MONTANA EYECARE- HELENA 1 NORTHERN MT VISION CENTER 1 REHDER HEARING CLINIC 1 SIDNEY HEALTH CENTER- AUDIO 1 ST PETERS HOSP-DIAGNOSTIC IMAG 1 ST PETERS MEDICAL GROUP-AUDIOL 1 ST VINCENT HOSPITAL-CARDIOPULM 1

Total 4264 North Dakota FY 2017

KEY ONSITE ADDITIONAL PRIMARY SECONDARY INSTITUTION DOCTOR ADDRESS_1 ACITY STATPROVIDER VISIT NOTES C748 ST CLAIRE, LYNN PO BOX 2344 BELCOURT ND NO NO C175 COAL COUNTRY COMM HEALTH CTR JACKSON, ORLAN 1312 HWY 49 NW BEULAH ND NO NO C2 01 SANFORD MEDICAL CENTER ENT ARNESON-THILMONY, DEB 225 N 7TH ST BISMARCK ND NO NO C154 DAKOTA EYE INSTITUTE BALLIET, PAUL 200 S 5TH ST BISMARCK ND NO YES C154 DAKOTA EYE INSTITUTE BEATTIE, SHARON 200 S 5TH ST BISMARCK ND NO YES

C15 08 BISMARCK RADIOLOGY ASSOCIATES BISMARCK RADIOLOGY ASSOCIAT BISMARCK RADIOLOGY ASSOC BISMARCK ND NO NO C2 01 SANFORD MEDICAL CENTER ENT BOUTILIER, AMANDA 225 N 7TH ST BISMARCK ND NO NO C18 01 CENTER FOR FAMILY MEDICINE CENTER FOR FAMILY MEDICINE PULMONARY DEPT BISMARCK ND NO NO

C18 02 CENTER FOR FAMILY MEDICINE CENTER FOR FAMILY MEDICINE 701 E ROSSER AVE BISMARCK ND YES YES KEY PROVIDER C18 CENTER FOR FAMILY MEDICINE CLAUSON, RYAN 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE DAVIS, ABBY 701 E ROSSER AVE BISMARCK ND NO NO C168 THE EYE CLINIC OF ND HANSTED, TOM 620 N 9TH ST BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE HENDRICKSON, MEGHAN 701 E ROSSER AVE BISMARCK ND NO NO C2 20 SANFORD HEALTH SPEECH THERAPY ISAACSON, DEB 300 N 7TH ST BISMARCK ND NO NO C239 CHAMBERS & BLOHM JOHNSON, ROBERT PSYCHOLOGICAL SVCS BISMARCK ND NO NO ONSITE VISIT C40 KEHRWALD, EDWARD 721 MEMORIAL HIGHWAY BISMARCK ND YES NO IN 2016 C41 KUCHLER, CHRISTINE J 721 MEMORIAL HIGHWAY BISMARCK ND NO NO C722 LINK PSYCHOLOGICAL SERVICES PC LINK, JAMES P 1424 W CENTURY AVE STE 207 BISMARCK ND NO YES C2 20 SANFORD HEALTH SPEECH THERAPY LOCKREM, TRACEY 300 N 7TH ST BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE MARQUARDT, JARED 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE MICKELSON, SCOT 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE MUGHAL, AYESHA 701 E ROSSER AVE BISMARCK ND NO NO C2 01 SANFORD MEDICAL CENTER ENT NELSON, JEFFREY 225 N 7TH ST BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE OSTGARD, ESTELLE 701 E ROSSER AVE BISMARCK ND NO NO C154 04 DAKOTA EYE INSTITUTE RANUM, MICHAEL 3119 N 14TH ST BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE SAHAI, PRIYA 701 E ROSSER AVE BISMARCK ND NO NO

C2 10 SANFORD HEALTH RADIOLOGY DEPT SANFORD HEALTH RADIOLOGY DE PO BOX 5525 BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE SAUTER, SHANNON 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE SNUSTAD, BRITTANY 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE SOMERS, TYREL 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE THUEN, BOBBI RAE 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE TINCHER, AMBER 701 E ROSSER AVE BISMARCK ND NO NO C168 THE EYE CLINIC OF ND TOWLE, STEVEN 620 N 9TH ST BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE WANZEK, RACHEL 701 E ROSSER AVE BISMARCK ND NO NO

C239 CHAMBERS & BLOHM WEISZ, SHANNON PSYCHOLOGICAL SVCS BISMARCK ND YES YES KEY PROVIDER C18 CENTER FOR FAMILY MEDICINE WHITE, CHRISTINE 701 E ROSSER AVE BISMARCK ND NO NO C18 CENTER FOR FAMILY MEDICINE YOUSUF, SADAF 701 E ROSSER AVE BISMARCK ND NO NO C95 01 FAMILY VISION CENTER DUNDERLAND, PAUL 522 MAIN ST BOTTINEAU ND NO NO C185 01 SOUTHWEST MEDICAL CLINIC LANCHBURY, FORREST 12 6TH AVE SW BOWMAN ND NO NO C185 01 SOUTHWEST MEDICAL CLINIC TOMBOULIAN, SHERRYL J 12 6TH AVE SW BOWMAN ND NO NO C55 02 CARRINGTON HEALTH CTR-LAB CARRINGTON HEALTH CTR-LAB 800 4TH ST N CARRINGTON ND NO NO C54 01 FOSTER COUNTY MED CENTER HOFF, BRAD 820 5TH ST N CARRINGTON ND NO NO C59 02 ST LUKE'S HOSPITAL ST LUKE'S HOSPITAL PO BOX 10 CROSBY ND NO NO C58 01 CROSBY CLINIC WARREN, GINGER 702 1ST ST SW CROSBY ND NO NO C99 01 NORTHEAST EYE CENTER PC DICKEN, ROBERT 404 HIGHWAY 2 EAST DEVILS LAKE ND NO NO C128 01 ALTRU CLINIC LAKE REGION FLEISSNER, PAUL 1001 7TH ST NE DEVILS LAKE ND NO NO C66 05 ALTRU CLINIC LAKE REGION GREEN, MANDY 1001 7TH ST DEVILS LAKE ND NO NO Onsite visit performed C704 01 BLOOMING PRAIRIE ASSESS CENTER HOFFARTH, JENNIFER 211 4TH STREET NE STE 4 DEVILS LAKE ND YES NO FY2015 C66 05 ALTRU CLINIC LAKE REGION LAPP, GREG 1001 7TH ST DEVILS LAKE ND NO NO C103 MEDICAL IMAGING ASSOCIATES MEDICAL IMAGING ASSOCIATES PO BOX 801 DEVILS LAKE ND NO NO C102 01 MERCY HOSP RESP THERAPY DEPT MERCY HOSP RESP THERAPY DEP 1031 7TH ST E DEVILS LAKE ND NO NO Onsite visit performed FY C704 01 BLOOMING PRAIRIE ASSESS CENTER SODERSTROM, JOCELYN 211 4TH STREET NE STE 4 DEVILS LAKE ND YES NO 2015 C170 REHAB VISIONS ABEL, AMBER 683 STATE AVE STE B DICKINSON ND NO NO C170 REHAB VISIONS ANDRADE, BRIANNA 683 STATE AVE STE B DICKINSON ND NO NO C222 DICKINSON FAMILY COUNSELING BAER, ROBERT 11 2ND AVE E STE B DICKINSON ND NO NO C44 WESTWIND CONSULTING CENTER FEHR, ALAN 135 W VILLARD ST DICKINSON ND NO NO C26 GREAT PLAINS CLINIC GOLD, MARY ANN 33 9TH ST W DICKINSON ND NO NO C44 WESTWIND CONSULTING CENTER HALL, SHELLY 135 W VILLARD ST DICKINSON ND NO NO C236 KELLER, JESSICA EYEWEAR CONCEPTS DICKINSON ND NO NO C26 GREAT PLAINS CLINIC RATHGEBER, CORY 33 9TH ST W DICKINSON ND NO NO C236 SHILMAN, NATE EYEWEAR CONCEPTS DICKINSON ND NO NO C10 02 ST JOSEPHS HOSP RESP THER DEPT ST JOSEPHS HOSP RTU 2500 FAIRWAY STREET DICKINSON ND NO NO

C14 O1 ELGIN COMMUNITY CLINIC GOYAL, DEEPAK C/O JACOBSON MEMORIAL HOSPITAL ELGIN ND NO NO

C14 O1 ELGIN COMMUNITY CLINIC RIVINIUS, CAREY C/O JACOBSON MEMORIAL HOSPITAL ELGIN ND NO NO C237 CATALYST MEDICAL CENTER BELLIS, MORRIS 1800 21ST AVE S FARGO ND NO NO C7 03 ESSENTIA HLTH SPEECH PATHOLOGY BOOTH, JILL 1702 S UNIVERSITY DR FARGO ND NO NO C237 CATALYST MEDICAL CENTER BRAKKE, ROSE 1800 21ST AVE S FARGO ND NO NO C123 DARVEAUX, DION X 1308 23RD ST S LL STE G FARGO ND NO NO C20 FAMILY HEALTHCARE CENTER ESPEJO, NAPOLEON 301 NP AVE N FARGO ND NO NO

C21 INDEPENDENT RADIOLOGY SERVICES INDEPENDENT RADIOLOGY SERVI PO BOX 2746 FARGO ND NO NO C199 02 INTERNAL MEDICINE ASSOCIATES INTERNAL MEDICINE ASSOCIATE 1707 GOLD DR S STE 101 FARGO ND NO NO C162 07 SANFORD EYE DEPARTMENT JORDAN, ANDREW 1717 S UNIVERSITY DR FARGO ND NO NO C162 07 SANFORD EYE DEPARTMENT KELLY, BRENDAN 1717 S UNIVERSITY DR FARGO ND NO NO C237 CATALYST MEDICAL CENTER MATHISON, SUSAN M 1800 21ST AVE S FARGO ND NO NO C7 11 INNOVIS HEALTH EYE CLINIC METZGER, TODD 1702 S UNIVERSITY DR FARGO ND NO NO C162 04 SANFORD EAR NOSE & THROAT MOY, JUSTIN 737 BROADWAY FARGO ND NO NO C162 04 SANFORD EAR NOSE & THROAT OLSON, ARDELL 737 BROADWAY FARGO ND NO NO C764 PPI CONSULTING PHILLIPPI, JAY 1330 PAGE DR STE 202A FARGO ND NO NO C768 SEVEN DAY CLINIC NORTH RATAJCZAK, AMY 1100 19TH AVE NORTH FARGO ND NO NO C162 12 SANFORD HEALTH CENTER SANFORD HEALTH CENTER 737 BROADWAY AVE N FARGO ND NO NO C162 19 SOUTHWEST CHILDRENS CLINIC SETTY, ARVEITY R 2701 13TH AVE S FARGO ND NO NO C778 THOM, STEVEN B THOM EYE AND LASER CLINIC FARGO ND NO NO C199 INTERNAL MEDICINE ASSOCIATES YOHE, MARK 1707 GOLD DR S STE 101 FARGO ND YES NO C150 01 HOCHHALTER, SUSAN EARLY CHILDHOOD TRACKING FORT YATES ND NO NO C97 01 HEARTLAND EYE CARE PC HELGESON, MARK 415 HILL AVE GRAFTON ND NO NO C97 01 HEARTLAND EYE CARE PC HOENKE, JAMIE 415 HILL AVE GRAFTON ND NO NO C61 GRAFTON FAMILY CLINIC OMOTUNDE, JOSHUA O MD 155 14TH ST W GRAFTON ND NO NO C63 01 UNITY MEDICAL CNTR RT DEPT UNITY MEDICAL CNTR RT DEPT 164 W 13TH ST GRAFTON ND NO NO C772 01 QUOTABLE KIDS SPEECH & LANG ZIEGELMANN, KRISTIN 819 HILL AVE GRAFTON ND NO NO

C66 01 ALTRU CLINIC ADJEKUM, GLORIA 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 08 ALTRU CLINIC ALTRU CLINIC VASCULAR ULTRA SOUND DEPT GRAND FORKS ND NO NO

C66 09 ALTRU CLINIC ALTRU CLINIC RADIOLOGY DEPT GRAND FORKS ND NO NO

C66 11 ALTRU CLINIC-RADIOLOGY ALTRU CLINIC-RADIOLOGY PO BOX 6003 GRAND FORKS ND NO NO

C104 02 ALTRU HOSP RADIOLOGY DEPT ALTRU HOSP RADIOLOGY DEPT 1200 S COLUMBIA RD GRAND FORKS ND NO NO

C104 01 ALTRU HOSPITAL ALTRU HOSPITAL PULMONARY FUNCTION LAB GRAND FORKS ND NO NO

C112 01 ALTRU REHABILITATION CENTER ANDERSON, CASSIE 1300 S COLUMBIA RD GRAND FORKS ND NO NO

C66 04 ALTRU CLINIC BANSAL, ASHOK K PSYCHIATRY CENTER GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC BECK, GWENDOLYN 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC BRANDT, MACKENSIE 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C66 01 ALTRU CLINIC DOUVOYIANNIS, MILTIADIS 1000 S COLUMBIA RD GRAND FORKS ND NO NO

C96 NORTH DAKOTA EYE CLINIC DUNHAM, TOM 3035 DEMERS AVENUE GRAND FORKS ND NO NO ONSITE VISIT PERFORMED C66 01 ALTRU CLINIC GAUTHAM, SHANTA 1000 S COLUMBIA RD GRAND FORKS ND YES NO IN 2016

C772 QUOTABLE KIDS SPEECH & LANG KJONO, CHELSEY 2600 DEMERS AVE STE 106 GRAND FORKS ND NO NO

C112 01 ALTRU REHABILITATION CENTER MISKAVIGE, LINDSEY 1300 S COLUMBIA RD GRAND FORKS ND NO NO ONSITE VISIT PERFORMED C241 FAMILY INSTITUTE ROWAN, LESLIE 2100 S COLUMBIA RD STE 202 GRAND FORKS ND YES NO IN 2016

C772 QUOTABLE KIDS SPEECH & LANG VOLK, ANDREA 2600 DEMERS AVE STE 106 GRAND FORKS ND NO NO C67 CENTRAL DAKOTA CLINIC NYHUS, CHARLES 922 LINCOLN AVE HARVEY ND NO NO C781 ST ALOISIUS MEDICAL CENTER ST ALOISIUS MEDICAL CENTER 325 BREWSTER ST EAST HARVEY ND NO NO C7 08 ESSENTIA HEALTH JAMESTOWN BUSCH, TANIA 2430 20TH ST SW JAMESTOWN ND NO NO C153 PROFESSIONAL EYECARE CENTERS FROHLICH, DOUGLAS 210 10TH ST SE JAMESTOWN ND NO NO C153 PROFESSIONAL EYECARE CENTERS FRONK, KENT 210 10TH ST SE JAMESTOWN ND NO NO C46 01 JAMESTOWN HOSPITAL JAMESTOWN HOSPITAL RESPIRATORY CARE DEPT JAMESTOWN ND NO NO C157 LARSEN, RAYMOND (b) (6) JAMESTOWN ND NO NO C177 T&K SPEECH & LANGUAGE SERVICES LORENZ, KRISTY JAMESTOWN BUSINESS CENTER JAMESTOWN ND NO NO

C767 01 MILLER, ADAM D HORACE MANN INSURANCE BUILDING JAMESTOWN ND NO NO C7 08 ESSENTIA HEALTH JAMESTOWN TORRANCE, JAMES 2430 20TH ST SW JAMESTOWN ND NO NO C32 02 KULM COMMUNITY CLINIC HAUFF, ROSEMARY PO BOX B KULM ND NO NO C71 01 LANGDON CLINIC NOYES, RANDAL H 901 2ND ST LANGDON ND NO NO C31 LISBON AREA HEALTH SERVICES LISBON AREA HEALTH SERVICES PO BOX 353 LISBON ND NO NO C30 01 FAMILY MEDICAL CLINIC SHEETS-OLSON, BARBARA 10 9TH AVE E LISBON ND NO NO C79 01 MINOT CENTER FOR FAMILY MED ALI, NOOR A 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED BAAJ, MOHAMAD KARAM 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED BAHAL, PAUL 1201 11TH AVE SW MINOT ND NO NO C83 06 MEDICAL ARTS CLINIC BOGGARAPU, SHALINI 400 BURDICK EXPRESSWAY EAST MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED CHHIBBER, VISHAL 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED CHOI, TAE HO 1201 11TH AVE SW MINOT ND NO NO ONSITE VISIT PERFORMED C122 EATON, TIMOTHY (b) (6) MINOT ND YES NO IN 2016 C184 01 FICEK, KOLETTA M MINOT STATE UNIVERSITY MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED GREWAL, SHUBNEET 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED GUPTA, KARANVIR 1201 11TH AVE SW MINOT ND NO NO C81 04 TRINITY HOSP SPEECH PATHOLOGY HAALAND, CHELSIE 407 3RD ST SE MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED IDANGODAGE, HASITHA 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED JOSHI, PURWA 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED MAHATO, SANJU 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED MANGAT, SUNEET 1201 11TH AVE SW MINOT ND NO NO C83 11 MINOT ENT CLINIC MAXSON, JERRICA TRINITY HEALTH CENTER WEST MINOT ND NO NO ONSITE VISIT PERFORMED C85 MEHTA, RAJNIKANT 315 MAIN ST STE 102 MINOT ND YES NO IN 2016 C79 01 MINOT CENTER FOR FAMILY MED MONI, MONIKA 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED MOROLIA, PRASHANT 1201 11TH AVE SW MINOT ND NO NO C83 11 MINOT ENT CLINIC NECHODOM, TRICIA TRINITY HEALTH CENTER WEST MINOT ND NO NO C83 11 MINOT ENT CLINIC NOEL, MARK TRINITY HEALTH CENTER WEST MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED PANNU, PRINCE 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED PANT, SHRADHA 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED SANDRONI, PETER 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED SUBRAMANIYAN, GOWRI 1201 11TH AVE SW MINOT ND NO NO C79 01 MINOT CENTER FOR FAMILY MED TAUFIK, MIREILLE 1201 11TH AVE SW MINOT ND NO NO

C81 03 TRINITY HOSP CARDIO-PULMONARY TRINITY HOSP CARDIO-PULMONA 3 BURDICK EXPRESSWAY W MINOT ND NO NO C81 01 TRINITY MED CTR RADIOLOGY TRINITY MED CTR RADIOLOGY 1 BURDICK EXPRESSWAY W MINOT ND NO NO C202 TRINITY MEDICAL GROUP TRINITY MEDICAL GROUP PO BOX 5010 MINOT ND NO NO C81 04 TRINITY HOSP SPEECH PATHOLOGY WALSH, GEORGINE 407 3RD ST SE MINOT ND NO NO C93 PROFESSIONAL HEARING SERVICES WELLS, JESSICA 1400 37TH AVE SW MINOT ND NO NO C83 09 TRINITY REGIONAL EYE CARE WILLIAMS, DARRELL 2815 16TH ST SW STE 102 MINOT ND NO NO C83 09 TRINITY REGIONAL EYE CARE WOLSKY, CHAD 2815 16TH ST SW STE 102 MINOT ND NO NO ONSITE VISIT PERFORMED C39 01 ODDEN, RON HEARTLAND PROFESSIONAL BLDG MOORHEAD MN YES NO IN 2016 C19 03 SANFORD HEALTH OAKES CLINIC NAGALA, VANI 420 S 7TH ST OAKES ND NO NO C779 RATH PC, GEOFFREY PO BOX 491 OAKES ND NO NO C19 04 SANFORD HEALTH OAKES CLINIC SANFORD HEALTH OAKES CLINIC 420 S 7TH ST OAKES ND NO NO C105 02 PRESENTATION MED CTR RTU PRESENTATION MED CTR RTU RESPIRATORY THERAPY DEPT ROLLA ND NO NO C118 01 THORMAN, JOSEPH ROLLA EYE CLINIC ROLLA ND NO NO C124 03 ROLLA OUTREACH OFFICE VOLK, GREG 113 MAIN AVE EAST ROLLA ND NO NO C106 01 HEART OF AMERICA MED CTR RTU HEART OF AMERICA MED CTR RT 800 S MAIN RUGBY ND NO NO

C106 02 HEART OF AMERICA MEDCTR RADIOL HEART OF AMERICA MEDCTR RAD 800 S MAIN RUGBY ND NO NO C759 01 MOUNTRAIL CTY MEDICAL CENTER MOUNTRAIL CTY MEDICAL CENTE PO BOX 399 STANLEY ND NO NO C162 16 SANFORD CLINIC VALLEY CITY BUHR, JAMES 520 CHAUTAUQUA BLVD VALLEY CITY ND NO NO C162 17 SANFORD CLINIC WAHPETON BRAUN, LISA PA 332 2ND AVE N WAHPETON ND NO NO C162 17 SANFORD CLINIC WAHPETON GETZ, ARIANE M 332 2ND AVE N WAHPETON ND NO NO C162 17 SANFORD CLINIC WAHPETON MYRON, SARAH 332 2ND AVE N WAHPETON ND NO NO C93 04 PROFESSIONAL HEARING SERVICES KILTHAU, KELCI 104 MAIN ST S WILLISTON ND NO NO

C78 03 MERCY MEDICAL CENTER RT DEPT MERCY MEDICAL CENTER RT DEP RESPIRATORY THERAPY DEPARTMENT WILLISTON ND NO NO C83 10 TRINITY REG EYECARE WESTERN DK ROLES, CYNTHIA 1321 W DAKOTA PARKWAY WILLISTON ND NO NO C780 CW WIEBE MEDICAL CENTRE BLIGNAUT, JOHANN 385 MAIN ST WINKLER MB NO NO C206 SLUSKY, ALAN 136 MARKET AVE STE 350 WINNIPEG MB NO NO C32 01 WISHEK COMMUNITY CLINIC THIRUMALAREDDY, JOSEPH 1007 4TH AVE S WISHEK ND NO NO C239 1 CHAMBERS & BLOHM 309 N MANDAN STREET BISMARCK ND YES YES C787 1 RESSLER, SCOTT (b) (6) FARGO ND NO NO PERFORMS VIDEO CE's ONLY NO C793 HASE, HAROLD (b) (6) BISMARCK ND NO NO OFFICE Nebraska CE Oversight October 1, 2016 - September 31, 2017 Active CE Provider List

Volume & Key Onsite Provider Name/Group Speciality Provider Review Midtown Medical Group Barb Eckert PS X X Holly Filcheck PS X X Jennifer Linder PS X X Elizabeth Morell PS X X Joshua Needelman PS X X David Barton IN X X Nathan Bertoldo IN X X William Poulson IN X X Meryl Severson IN X X James Wax IN X X James Bisanti IN X X Antionette Tribulato IN X X Elizabeth Dayton IN X X Bradley Hall IN X X Kimberly Joynt IN X X Amanda Millemon IN X X Gene Pershwitz IN X X Jason Talmadge IN X X Community Action Partnership (CAPWN) IN Abdel Kader IN X X Gage Stermensky IN X X Elizabeth Walton IN X X Christopher Wiles IN X X John Carrington IN X X Caroly Herman IN X X AUDIOLOGIST Nora Fuch AU Lori Dailey AU Graig Foss AU Kimberly Andresen AU Roy Christensen AU OTOLARYNGOLOGIST Paul Sherrered EN Nila Novotny EN Thomas Kenny EN Sarah Powell EN Thomas Nabity EN V Richard Bowen EN

Nebraska 2016-17 FY CE Oversight Mark Keller EN Richard Bowen EN Kate Rosenberger EN Christopher Cederberg EN Benton Nelson EN Royce Mueller EN Terry Olson EN Brian Gartrell EN Dana Wolfe EN H Russell Semm EN Britt Thedinger EN INTERNIST (MDs, DO, PA, APRN) James Massey Jr IN Jeffrey Meade IN John Gill IN Michael Zaruba IN Mark Jobman IN Donald Weldon IN Brett Studley IN Juvet Che IN James Nelson IN Linda Mazour IN William Sandy IN Steven Saathoff IN Ruby Northrup IN Shiuvaun Jaeger IN Brenda Korth-Wurdinger IN Larry Birch IN X David Lindley IN Vijay Agarwal IN Mark Pilley IN Samuel Moessner IN Shailendra Saxena IN Adam Wineinger IN Carl Cornelius Jr IN Douglas Martin IN Mark McCorkindale IN Melvin Campbell IN Dana Farris IN Makayla Wiese IN William Blair IN Ruby Houck IN Jerry McLain IN Thomas Smith IN Brett Wergin IN Alyssa Finck IN Adam Rensch IN Nebraska 2016-17 FY CE Oversight Kathryn Thelen IN Kimberly Butts IN Thomas Fischer IN Benjamin Egger IN Kelli Garwood IN Marehan Nakhnoukh IN Stephen Smith IN Charles Burkett IN Ashley Powell IN Adam Strehle IN Justin Morar IN NEUROLOGIST Daniel Stevens NE C Robert Adam NE John Aita NE John Goldner NE Robert Sundell NE Joel Cotton NE John Hannam NE Manjula Tella NE

OPTHALOMOLOGIST/OPTOMETRIST David Franco OD Matthew Willis OD Roger Filips OD Jerry Damme OD Robert Stamm OD Dirk Gray OD Gregory Kouri OD Ann Feidler-Klein OD Jeffrey Klein OD Teri Geist OD Krystal Wells OD Scott Greder OD Matthew Willis OD J Todd Mahoney OD Paul Colburn OD Natasha Jenkins Long OD Terry Adams OD Penelope Haeker OD Janet Fett OD Daniel Kincaid OD Peter Diedrichsen OP Steven Samuelson OP Gregory Haskins OP Jan Jensen OP Linda Blakely OP Nebraska 2016-17 FY CE Oversight Frederick Mausolf OP Vincent Sutton OP Mario Mota OP Thomas Graul OP Lee Thurber OP Richard Maw OP Michael Feilmeier OP Jane Bailey OP David Ingvoldstad OP Cortney Hellman OP Martin Mizener OP Michael Goldstein OP Jeffery Hottman OP John Peters OP Mark Emig OP Matthew Appenzeller OP Peter Whitted OP D Francis Arkfeld OP Michael Halsted OP Camilla Parson OP Jill Grennan OP Daniel Sharp OP Monte Dirks OP Michael Wadzinski OP PEDIATRICIAN Eyad Najdawi PE Susan Caldwell PE Nitya Brenner PE Rex Rundquist PE PSYCHIATRIST/PSYCHOLOGIST Kay Shilling PS Robert Arias PS Justin Anderson PS James Mathisen PS Paul Adams PS Leland Zlomke PS Rebecca Schroeder PS Allen Meyer PS Brad Bigelow PS Linda Hunter PS Michael Renner PS David Duke PS John Meidlinger PS Kevin Menefee PS Ryan Ernst PS Lisa Logsden PS James Carmer PS Nebraska 2016-17 FY CE Oversight Daniel Ullman PS Thomas Tiegs PS Kimberly Kilgore PS Gail Ihle PS Eugene Egnoski PS John Curran PS Mark Nelson PS Mark Hannappel PS Amy T. Corey PS A James Fix PS X Gary Van Ert PS X X Matthew Hutt PS Caroline Sedlacek PS Sarah Schaffer PS Lloyd Lee Kimzey PS Joseph Rizzo PS Joseph Stankus PS Lindsey Hauser PS Rosanna Jones-Thurman PS Patricia Blake PS Kelly Fairbanks PS John Hunziker PS Amanda Holmgreen PS Mark Hald PS Suzanne Keizer PS Michael Baker PS Denise Marandola PS Dena Olwan PS Joel Merkwan PS Linda Schmechel PS Jack Kramer PS Nicholas Stevens PS PHYSICAL THERAPIST Jonathon Brezenski PT Randy Peraul PT Jay James Pelan PT Sue Jeffrey PT Sherril Kilpatrick PT Tiffany Beiermann PT Eric Bjorkman PT Kate Robb PT Brett Woslager PT Bruce Bednar PT Becky Pearson PT Bonnie Mevis PT SPEECH LAGUAGE PATHOLOGIST Martha Douglas SLP Nebraska 2016-17 FY CE Oversight Tracie Heckenlively SLP Ruth Anderson SLP Deb Fisher SLP Pam Peters SLP Shana Merrihew SLP Ashley Meyer SLP Jessica Ferfuson SLP Jennifer Arndt SLP Shannon Klimas-Bernitt SLP Elizabeth Weber SLP Noelle Lindauer SLP Mindy Uden-Roberts SLP Jessica Thoene SLP Volume & Key Onsite Provider Name/Group Speciality Provider Review Jessica Reuter SLP Alissa Brady SLP Connie Hanson SLP Deb O'Connor SLP Melissa Harmon SLP Carly Thomas SLP Kara McKeone SLP Paige Gurciullo SLP Mary K Miklas SLP Linda Lawlis SLP

Nebraska 2016-17 FY CE Oversight Nebraska CE Oversight October 1, 2016 - September 31, 2017 CE Terminated List

Provider Name/Group Speciality Reason Derrick Eichele IN Herman Hernandez IN (b) (6) Brian Hollis IN Jerry Authier PS Gary Gard PS Jeffrey Klug IN Joseph Kent PS Silas Williams IN Andrew Smith PS Cynthia Topf PS Keegan Harkin IN Natalie Ommen IN Patrick Anderel IN Chris Rathburn PS Helen Kuehlman IN William Packard PS David Johnson IN Christopher Costa IN Elaine Christiansen IN Melissa Kudlacek IN Matthias Okoye IN Adam Rusmussen IN Anna Darymple IN Mackenzie Hemje IN Douglas Bauer IN Rulin Wang IN Elizabeth Wooster IN Mansoor Ahmad IN Eli Burks IN Kunal Gandhi IN Bradley Irvin IN Guy Domm IN Angela McLaughlin IN Shibu Oommen IN Janae Dudgeon IN Jawad Ahmad IN Mohammad esmadi IN Edward Schima NE Colby Fletcher OP Ann Rehan PE

Nebraska 2016-17 FY CE Oversight John Engler PS Lisa Stinson PS (b) (6) Kari Perez PS Mary Ann Strider PS Kim Marlatt PT Lori Ford SLP Lynn Grubb SLP

Nebraska 2016-17 FY CE Oversight 2017 CE Providers- Nevada DDS

Active/ Inactive Vendor Name Vendor Address Rate Key/ VolumActive/ InactivReason OnSite Inspections Completed Medical Support Los Angeles 2110 E Flamingo Rd #216 Las Vegas, NV 89119 $289,922.00 Key/ VolumActive 6/20/2017

(b) (6) Desert Psychological 9183 W Flamingo Rd #100 Las Vegas, NV 89147 $189,205.00 Key/ VolumINACTIVE (b) (6) Intergrated Psych Solutions 2780 S. Jones Blvd #108 Las Vegas NV 89146 $188,350.00 Key/ VolumActive 6/8/2017

Innovative Medical LLC 1489 W Warm Springs Rd #110 Henderson, NV 89014 $158,898.00 Key/Volum Active 5/31/2017 Marc Zucker PsyD 4955 S Durango Dr. #221 Las Vegas, NV 89113 $134,905.00 Key Active Not completed Northern Nevada Psychology 309 E John St #1 Carson City, NV 89706 $105,691.00 Key Active 6/22/2017 Lisa M Foerster PsyD 9163 W Flamingo Rd #120 Las Vegas, NV 89147 $103,250.00 Key Active Not completed AMCE Physicians Group 5365 Mae Anne Ave #B-2 Reno, NV 89523 $99,135.00 Key Active LV-5/22/17 Reno-6/21/17 Myra Thompson Psyd LLC 6069 S Fort Apache Rd #100 Las Vegas, NV 89148 $96,510.00 Key Active 8/23/2017 Kathleen S Mayers PhD 4550 W. Oakey Blvd. # 111, Las Vegas, NV 89102 $89,445.00 Key Active Not completed

Verna Fabella Hicks PhD 2881 Business Park Courte #150 , Las Vegas NV 89128 $76,420.00 Key Active 8/15/2017 Richard A Cestkowski DO 6655 W Sahara Ave #D100 Las Vegas, NV 89146 $74,691.50 Key Active Not completed Michael Glick, DO (b) (6) St Reno , NV 89511 $74,513.00 Key Active 6/21/2017 Rager Diagnostics and Behavior 1050 Indigo Dr. #112, Las, Vegas, NV 89145 $63,590.00 Key Active Not completed

Gary Lenkeit PhD 1820 E Warm Springs Rd #115 Las Vegas, NV 89119 $54,885.00 Key Active Not completed SFS Therapies/ SYD Nukleo 1333 N. Buffalo Drive, #260, Las Vegas, NV 89128 $49,520.00 Key Active 10/19/2017 R Kirby Reed LTD (b) (6) Las Vegas, NV 89120 $44,380.00 Key Active Not completed Shrinkwrapt Las Vegas LLC 2580 Anthem Village Dr Henderson, NV 89052 $41,270.00 Key Active 5/31/2017 RBM Clinic 2675 S. Jones Blvd, #112, Las Vegas, NV 89146 $39,842.00 INACTIVE (b) (6) Inactive Elizabeth James PhD 4955 S Durango Dr. #221 Las Vegas, NV 89113 $37,449.00 Key Active Not completed L.D Larson PhD (b) (6) Las Vegas, NV 89146 $35,935.00 Key Active Not completed Psych Inc 200 S Virginia St 8th Floor Reno, NV 89501 $33,870.00 Key Active 10/12/2017 SDMI Limited Partnership 7301 Peak Dr #200 Las Vegas, NV 89128 $29,754.50 Non Key Active Not completed Daniel Malatesta EdD (b) (6) Las Vegas, NV 89129 $29,150.00 Key Active Not completed Spencer Quinton OD 305 N Pecos Rd #A Henderson, NV 89074 $26,165.00 Non Key Active 5/31/2017

Radiology Consultants/Reno Diagnostics 590 Eureka Ave, Reno, NV 89512 $22,639.00 Non Key Active 9/13/2017 Julius M Rogina PhD 427 Ridge St #A Reno, NV 89501 $22,225.00 Key Active 6/22/2017 Wendy Riback (b) (6) Las Vegas, NV 89117 $18,485.00 Key Active Not completed Maria Doncaster PhD 3450 E Russell Rd #103 Las Vegas, NV 89120 $17,795.00 Key Active 6/1/2017 Nevada Heart Consultants 3017 W Charleston Blvd #80 Las Vegas, NV 89102 $12,510.00 Key Active 8/17/2017

RD Prabhu Lata K Shete MDS 5701 W Charleston Blvd #100 Las Vegas, NV 89146 $12,217.00 Non Key Active Not completed Nevada Education & Therapy 500 Ryland St #150 Reno, NV 89502 $11,005.00 Non Key Active Not completed

Valley Pediatric & Specialty 3100 W Charleston Ave #210 Las Vegas, NV 89102 $10,720.00 Non Key Active Not completed Olympus Health Nevada LLC 700 N. Carr Road, Plainsfield, IN 46168 $10,523.50 Key Active Not completed Tyson F Kales OD (b) (6) Reno, NV 89502 $8,865.00 Key Active 8/30/2017 Lubritz & Nasri LLP 3201 S Maryland Pkwy #300 Las Vegas, NV 89109 $5,516.00 Non Key Active (b) (6) Not completed Concentra Medical Center 255 Glendale Ave #12 Reno, NV 89431 $4,854.00 Non Key Active 10/12/2017 Martha Mahaffey PhD (b) (6) Reno, NV 89502 $4,710.00 INACTIVE Inactive Reflections Therapy 2620 Regatta Dr. #202, Las Vegas, NV 89128 $4,250.00 Key Active 8/8/2017 Anderson Audiology 3120 S Rainbow Blvd #202 Las Vegas, NV 89146 $3,366.00 Non Key Active 5/23/2017 Complete Family Care Ltd 255 W Peckham Ln #2 Reno, NV 89509 $2,410.00 Non Key Active 9/14/2017 John R Shepherd MD LTD (b) (6) Las Vegas, NV 89121 $2,345.00 INACTIVE Inactive Neurology Center Of Las Vegas 2480 Professional Ct Las Vegas NV 89128 $2,050.00 Non Key Active Not completed Zucker, Irene 4955 S Durango Dr. #221 Las Vegas, NV 89113 $1,550.00 Non Key Active Not completed Not completed- Using one of Dr. Odyssey Wellness-Dr. Ahmad 9183 W. Flamingo Rd, Las Vegas, NV 89147 $1,350.00 Non Key Active Hollands offices David L Mathis MD (b) (6) Reno, NV 89523 $1,012.00 Key INACTIVE Inactive Silver State Hearing & Balance 501 Hammill Ln Reno, NV 89511 $770.00 Non Key Active 9/13/2017 Estella O Racoma LLC 2675 S Jones Blvd #112 Las Vegas, NV 89146 $770.00 Non Key INACTIVE Inactive Kenneth W Houchin MD (b) (6) Elko, NV 89801 $495.00 Non Key Active 9/12/2017 Carson Tahoe Cardiology 1470 Medical Pkwy #160 Carson City, NV 89703 $312.00 INACTIVE Inactive Sierra Speech and Language DBA Sierra Therapy Group 9520 Prototype Ct Reno, NV 89521 $170.00 Non Key Active Not completed Pinion Road Clinic 1780 Browning Way Elko, NV 89801 $156.00 Non Key Active 9/12/2017 Marietta Nelson 2800 N Tenaya #102 Las Vegas, NV 89128 $100.00 Non Key Active Not completed Stacey Knobler MD (b) (6) Reno, NV 89509 $0.00 Non Key Active 9/13/2017 Yesnick Vision Center 10198 W Flamingo Rd #100 Las Vegas, NV 89147 $0.00 Non Key Active Not completed Warner Wilson PHD 3376 S Eastern Blvd #120 Las Vegas, NV 89109 $0.00 Non Key Active Not completed Valette Group/Jurani Clinic 4520 Paradise Rd Las Vegas, NV 89169 $0.00 Non Key Active Not completed

Dr. Lesile Westfield PhD (b) (6) , Henderson, NV 89074 $0.00 Key Active 9/27/2017 Innovation Behavioral Health 6655 W. Sahara Ave. #B200, Las Vegas, NV 89146 $0.00 Key Active 9/5/2017

Dr. Bree Mullins PsyD 1820 E Warm Springs Rd #115 Las Vegas, NV 89119 $0.00 Key Active Not completed Dr. Sunshine Collins PsyD 9163 W. Flamingo Rd. #120, Las Vegas, NV $0.00 Key Active Not completed Dr. Jacquelyn Johnson PsyD (b) (6) Reno, NV 89509 $0.00 Key Active 10/13/2017 Moonlight Examinations 4300 Anaconda Ct, Granberry, TX 76048 $0.00 Key Active 10/12/2017 Marilyn Maschgan AuD 301 N. Pecos Rd, #G, Henderson, NV 89074 $0.00 Non Key Active 8/10/2017 New Mexico FY 2017

COLOR KEY: INACTIVE - within FY17 Beginning FY17 = 137 136-6+11=141

SANCTIONS Removed = 10 TOP 5 KEY/VOLUME PROVIDERS Added = 14 Includes 3 additional locations for Fillmore Previously lumped together; Ending FY17 = 141 adjusted to make consistent with other providers

Site Visit VENDOR NAME / FACILITY NAME FACILITY PHYSICIAN NAMES NOTES Removed Added Location Date 150 10 14 ABQ HEALTH PARTNERS (DaVita) Nagaraju, Sivakumar Nazon, Daniel Roswell 1/25/2017 ADAMS, CARL B PHD ADVANCED MEDICAL CONSULTANTS (Dr. Newell -- contact) Chavez, Juliana Clark, Ross El-Emawy, Ahmed Dr. Newell stated Dr Evans moved out of state - not Evans, Scott D. working here Fitzgerald, Judd Garzon Lopez, Agustina C. (goes by Dr. Garzon) Maes, Levi McKinney, Michael Richter, Dustin AGE TO AGE COUNSELING Albuquerque 12/16/2016 Spies, Shari ALAMOGORDO INTERNAL MEDICINE Anireddy, Giridhar R. Hanumandla, Sarojana (Mary Spilman, Financial ALBUQUERQUE HEARING ASSOCIATES Coordinator) Almquist, Elaine Clifford, Carol Molloy-Sawyer, Patricia ALTA VISTA REGIONAL HOSPITAL - use Rural Radiology Las Vegas 4/27/2017 for XR AMCE LISW (LC, Hobbs, Roswell, Silver City) - Removed as of Albuquerque 12/16/2016 Black, Marian (LISW) 7/13/17 per Linda DeBernardi, Amy Draper, John Macy, Ruth (LISW) NO Longer works w/ AMCE; last appt 6/28/17 No longer works w/AMCE; inactivated 8/18/17 per McCanna, Charles email added per email received 03/16/17, inactivated 7/6/17 Mead, Diane R. (LISW) per email request Schaefer, Shayna (LISW) no longer on staff per email received 03/16/17 Schweiger, Russell (LISW) no longer on staff per email received 03/16/17

AMPLIFIED THERAPY Bradberry, Shalako SLP-CCC Inactive as of 9/28/16 - but was not removed from ANDERSON, N PHOENIX 2016 X ARIS TELERADIOLOGY (xray interpretation for Miner's Colfax MC) Barnes, Patricia Bass, David Cavin, Lillian Dier, Gary Fisher, Timothy Sebastian Galvez, Michelle Grebenc, Mary Hatch, Wendell Hsu, James Jacobson, Leslie Luyckx, Benoit Maung, Tony Minotti, Anthony Norconk, James Patterson, Richard Shah, Abhijit Wohlwend, John ARTESIA GENERAL HOSPITAL -- use Pinon Radiology for XR Anwar, Khawaja 9/12/17 Inactive Batty, John Feroze, Hamid Spar, Jon Atkinson, Leah FPNP *New Provider as of 6/21/17 X AUDIO ACOUSTICS HEARING CTR INC Corbin, Kambra Gonzalez Rodriguez, Angelica Santa Fe 7/13/2017 BATEN, MICHAEL MD BEHAVIORAL MEDICINE ASSOC. INC *New Vendor as of 4/19/17 X Whitlock, Brian Jimenez, Julie MSW Trevizo, Karla MA BELL, ROBERT M MD *New Vendor w/Locations in Silver City and Deming as Border Area Mental Health of 6/21/17 X Kathleen Hunt, LPCC Silvia Madrid, LPCC

Portales 9/28/2017 BROOKS, CHARLES Caplan & Associates Caplan, Marc PhD *New Vendor a s of 9/22/17 X Guglielmina, Aria CARDIAC CARE CONSULTANTS OF NM P.C. ABQ/Los Lunas/Belen/Rio Rancho/Gallup/LV Gurule, Michael Ierides, Loutsios

Palmer, Elizabeth Sandoval, Anthony CARLSBAD MEDICAL CENTER Ardakani, Navid Braude, Darren Caverly, Jeffrey Conner, Patrick Dara, Bharat Davenport, Jennifer Dewan, Rahul Dubey, Neeraj Ervin, William Gallegos, Emmanuel Gonzalez-Villaverde, Alberto Gurczak, Patricia Holmes, Gerard Hopson, Gabriele Kampe, Delmar Kuehn, Nicolaus Limonte, Leonel Lis, Steven Lue, Jason Mangat, Jagjit Mehta, Nikhil Mitchell, Richard Munoz, Julio Newell, Peter Patel, Atul Piampiano, Peter Qureshi, Huma Reed, Peilin Reuter, Robert Rippner, Robert Ruzich, Jeffery Sarno, Ronald Sobredo, Sergio Vincent, Alix Wayburn, Lawrence Zwiener, John Farmington 4/10/2017 CE PROVIDER SERVICES Clawson, Diane Colleran, Kathleen M.

Como, Jennifer Glassheim, Jeffrey McBride, Sandra CIBOLA GENERAL HOSPITAL - use XR Assoc for radiology & NMHI Cardiology CLAYTON, STARLIA MSCCC-SLP CUMMINGS, MICHAEL A PHD DAN C TRIGG MEMORIAL HOSPITAL (uses Radiology Assoc of ABQ) Derri Pender

Las Cruces 3/15/2017 DARAKJY, JENNIFER PHD DELANEY, MARITA PHD Rio Rancho 5/19/2017 DHANENS, THOMAS DINSMORE, ELIZABETH PHD Inactive as of 1/12/17 X EASTERN NEW MEXICO MEDICAL CENTER - use Online address licensing letters to Shill Rad. For XR Breedyk Business Office Adajar, Fundador Feroze, Hamid Pearson, Clarence EAST MOUNTAIN HEARING & BALANCE Pulsipher, Lisa EMERY, MICHAEL ESPANOLA HOSPITAL -- Use RAA for XR EYE ASSOCIATES OF NEW MEXICO/ABQ-Eubank Michelle Butcher, Credentialing Achilles, Amanda Dudeck, Kirsten Koschmeder, Jason McGraw, Matthew D. Roland, Nathaniel 10/31/16 Provider moved out of state EYE ASSOCIATES OF NEW MEXICO/ABQ-Harper Achilles, Amanda Allen, Rebekah Armentrout, Matthew Beebe, Ellen Bobick, Lauren Brinkley, John Cano-Howes, Melinda A. Also at the Los Lunas office Carlow, Thomas Chan, VanLin Chang, Lan Chiang, Charles Dimonaco, Michael Durso, Frank Goecks, Tara M. Himmel, Kenneth Lesher, Mark Mares, Frank Marsh, Barbara McGraw, Matthew D. Monson, Bryan Morris, Cara Ogawa, Gregory Pitcher, John Ramaiya, Kamalesh Ritsema, Molly Ritz, Nicholas Roybal, Christopher Sanchez, Philip James Song, Mi-Kyoung Vroman, Craig Watterberg, Tina Weinstein, Arthur EYE ASSOCIATES OF NEW MEXICO/ABQ - MLK Beebe, Ellen Bobick, Lauren Cano-Howes, Melinda A. Also at the Los Lunas office Chiu, Mark McGraw, Matthew D. Reddy, Ashok Reidy, Robert Wieland, William Wyant, Frank EYE ASSOCIATES OF NEW MEXICO/Espanola Bratton, Angela Coulter, Julia Rorebeck, Warren Farmington 4/10/2017 EYE ASSOCIATES OF NEW MEXICO/Farmington Kleva, Julie Wiggins, Duane Gallup 10/17/2016 EYE ASSOCIATES OF NEW MEXICO/Gallup Chiang, Charles Bobick, Lauren Kim, Marissa McGraw, Matthew D. Roybal, Christopher EYE ASSOCIATES OF NEW MEXICO/Las Vegas

Vander Meer, Robert emailed contact 9/19/16 - License shows "retired" EYE ASSOCIATES OF NEW MEXICO/Los Alamos Johnson, Timothy EYE ASSOCIATES OF NEW MEXICO/Los Lunas Cano-Howes, Melinda A. EYE ASSOCIATES OF NEW MEXICO/Roswell

Fitch, Patricia Will begin seeing patients at Eye Assoicates on 5/2/16 Hillam, Steven Roybal, Christopher EYE ASSOCIATES OF NEW MEXICO/Rio Rancho Achilles, Amanda Bigelow, Daryl Goecks, Tara M. Melendez, Robert F McGraw, Matthew D. Roybal, Christopher Strosnider, Jeff C EYE ASSOCIATES OF NEW MEXICO/Santa Fe Achilles, Amanda Byrne, Erin Coulter, Julia Cyr, Kelly Fitch, Patricia Goecks, Tara M. Himmel, Kenneth Javid, A.J. Levy, Renny Reidy, Kristin Roybal, Christopher Soloway, Mahlon EYE ASSOCIATES OF NEW MEXICO/Socorro Office closed 9/1/17 X Beebe, Ellen Cano-Howes, Melinda A. EYE ASSOCIATES OF NEW MEXICO/Taos contact emailed on 9/14/16; remains expired as of Morrison, John Jr. 11/1/16 Oneby, Terri Rorebeck, Warren Las Cruces 3/16/2017 EYES OF THE SOUTHWEST PC Apple, Neal Hernandez, Edward Per letter dated 05/02/17, provider no longer active Mohammed, Andrew eff 05/01/17 Las Cruces 3/16/2017 FILLMORE EYE CLINIC INC - Las Cruces Multiple offices - Providers rotate Anderson, Aaron Fillmore, Parley Hall, Jon Hicks, Brandon Margolis, Michael

Alamogordo 3/30/2017 FILLMORE EYE CLINIC INC - Alamogordo providers listed above X Deming 5/25/2017 FILLMORE EYE CLINIC INC - Deming providers listed above X FILLMORE EYE CLINIC INC - T or C providers listed above X

2/28/2017 Clovis 9/27/17 FINK, RICHARD PHD FOSTER, ELAINE ORABONA PHD FOUR CORNERS RADIOLOGY (XR interpretatio for San Juan RMC) Bliss, Lynne F Bray, Macey Orbelo, Robert Weaver, Robert Roy Webster, John Roger III Wolske, Kristy Marie GERALD CHAMPION REGIONAL MEDICAL CENTER (2nd Alamogordo 3/30/2017 Xray Assoc)

Abood, Ferial Alqassem, Nasser Anireddy, Giridhar Fellers, Neal Hanumandla, Sarojana GILA REGIONAL MEDICAL CENTER - (use Rural Radiology Silver City 3/13/2017 for XR) GUADALUPE COUNTY HOSPITAL (Use High Plains Rad for XR) Brown, Randal Calkins, David Cambron, Bradford Cisneros, Raquel Maes, Levi Gutierrez, Rhonda LPCC *New Provider as of 9/12/17 X Espanola 2/9/2017 GZASKOW, MICHAEL F MD HARRINGTON, JAMES PHD HEARING GROUP OF NM Correa, Jose Vigil, Diana Au.D. HERLIHY, KERRI SPEECH PATHOLOGY HIGH PLAINS RADIOLOGY ASSOCIATION - (Union & Guadalupe Co) Andrew, John L. MD, DABR Aragon, Gary L. MD, DABR Archer, Branch T. MD, DABR Archer Jr., Richard K. MD, DABR Bickers, Gayle H. MD, DABR Brooks, Charles MD, DABR Clark, Crandon MD, DABR Cook, Stanley MD, DABR Currie, Tully Jenks MD, DABR 11/1/16 - not renewed Daniel, Michael MD, DABR Elliott, Aaron MD, DABR

Haas, Stephan MD, DABR Hall, Michael MD, DABR Hashmi, Arouj MD, DABR Khu, Richard C. MD, DABR Mehta, Rahul MD, DABR Pan, Paul P. MD, DABR Pinkston, Robert L. MD, DABR

Scalapino, Matthew C. MD, DABR Shah, Rakesh R. MD, DABR Uszynski, Martin MD, DABR Waugh, Kimberly A. MD, DABR 11/1/16 - not renewed Zarian, Lawrence MD, DABR

HOLY CROSS HOSPITAL - use Rural Radiology for XR Constantin, Luis MD Ismail, Geilan MD Kaufman, Michael H Albuquerque 12/21/2016 HUGHSON, PAULA MD Albuquerque 6/1/2017 HUNT, MARY SPEECH PATHOLOGY *Provider will be moving out of state end of 2017 Hush, Rachael Speech Pathology *New Provider as of 8/18/17 X JOHNSON-JIMENEZ, ERIKA PHD Ruidoso 3/29/2017 KENNEY, KENNETH C. KENNETH KENNEY, PhD School Psychologist - license on NM Public Education Torres, Rebecca M (NCSP) Department KING, EMILY PSYD *Inactive as of 9/6/17 - no location X Farmington 4/10/2017 KOEWLER, JOHN H III Santa Fe 2/9/2017 KRUEGER, ROBERT PHD Albuquerque 12/21/2016 LACOURT, DAVID PHD Espanola 2/9/2017 LANG, JOHN PHD LAS CRUCES RADIOLOGY ASSOC Kathleen Parsons, Credentialing Devasthali, Ramakrishna Ghei, Puneet Hobbs 1/24/2017 LEA REGIONAL MEDICAL CENTER Kernan, John B Maddox, Truett Patel, Mukeshbhai

Pfaff, Charles Order to be released from board order dated 5/21/10 Techeira, Aemon Lesko, Paul MD *New Provider as of 8/18/17 X LIFESPAN THERAPY SERVICES Sandy Custer, Practice Manger *Inactive as of 9/28/16 but not removed in 2016 X Castle, Kathleen Davis, Kindra Holifield, Julie C Las Cruces 3/16/2017 LIFEWORKS UNLIMITED Castellanos, Luisa Carlsbad 8/24/2017 LIM, MICHAEL MD Ruidoso 3/28/2017 LINCOLN COUNTY MEDICAL CENTER

Robinson, Walter C LINCOLN COUNTY RADIOLOGY (Reads for Lincoln Co MC) Devasthali, Ramakrishna MD Ghei, Puneet Smiley, Hylas Spera, Thomas Techeira, Aemon Wolfel, Donald

LITTLEFIELD, JERALD J MD X Albuquerque 12/21/2016 LOESCHER, MARY S PHD Albuquerque 3/7/2017 LOVELACE SCIENTIFIC RESOURCES McGuire, Michael Manole, Athanasios, MD *New Provider as of 8/15/17 X MAY-VALENCIA, BARBARA PHD MEDICAL DIAGNOSTICS IMAGING GROUP (interprets for Sierra Vista) Carr, Barbara Chung, Eugene Eelkema, John Fenzl, Gregory Finkel, Lawrence Fiske, Shirley Ingui, Christian Jalalzai, Waheed Kazem, Imran Lin, Irene McCarver, Robert Patel, Kalpesh Patel, Rakesh Roy, Anjali Ruvo, Veronica Sadegi, Barry Shah, Abhijit Stair, Doris Weitz, David Willey, Richard Wolsey, Gilman Zernich, Brian MEDICAL DIAGNOSTICS SERVICES (interprets for San Juan Regional) Barry-Prather, Eleanore Ann Glover, Donald K Spence, James J Tori Quimby-- Program MED-PLUS Administrator Albuquerque 12/21/2016 Alshurbaji, Ehab no longer with Med-Plus after 2/2017 Hobbs 1/24/2017 Andrews, Nathan Roswell 1/26/2017 Bagga, Arlene 11/1/16 works with UNM/VA - Med Plus does not Silver City 3/13/2017 Brisky, Martha (PHD) perform psych evals Las Cruces 3/15/2017 Chen, Yuefeng Farmington 4/13/2017 Cheng, Terri Clawson, Diane Crumbacher, James Decker, Michael Fishburn, Steven Fleg, Anthony Greenburg, David Greene, Heather Greer, Kyle Greig, Elizabeth (name change to Hopson) name change to Hopson Guerrero-Pezzano, Tatyana Haaland, Christina Hammons, Laura Hindi, Yousef Hopson, Elizabeth Larson, Andrew Maes, Levi Also works for Advanced Medical Nunez, Willie Pastrana, Carlos no longer w/ med-plus as of 3/2012; reactivated Ponce, Liana 8/9/17 Pou, Nelson

Rossini, Juan Scott, Ariel Joy Silverthorne, Patrick Young-Rodriguez, Raul MILLER, FRANKLIN (PFS Interpretation for Alta Vista Las Vegas 4/26/2017 Hospital) Deming 3/14/2017 MIMBRES MEMORIAL HOSPITAL Atkinson, George Dubey, Neeraj Lahiri, Sanjay Pham, Justin Saurborn, Daniel Tan, Kenneth (Radiology 24/7)

Raton 4/25/2017 MINERS COLFAX MEDICAL CENTER (Use ARIS for XR) Henrietta Romero (licensing) Sood, Akshay Albuquerque 5/20/2017 MOBILE CARE CONCEPTS Clark, Ross Greenbaum, Alissa Lunkenheimer, Jared McClain, Molly Yoon, Moon NADIG, CHARULATA *Inactive as of 9/6/17 X Albuquerque 12/16/2016 NEW MEXICO HEART INSTITUTE/ABQ no longer in roswell Bieniarz, Mark Bujoi, Mihaela Castlemain, Brian Cavanaugh, Brendan Downey, Ross Frankis, Mary Henao, Esteban Kim, Charles Kunz, Geoffrey Mansfield, William Mazer, Sean

Orchard, Robert Peralta, Mel Ramo, Barry Ronan, Adam Sopko, Karen Stamm, R. Brad Wyndham, Christopher Zolnick, Mark Farmington 4/10/2017 OLYMPUS HEALTH Albuquerque 5/20/2017 Greene, Heather Las Cruces 8/7/2017 Larson, Andrew Manole, Athanasios now working separately Musgrave, Zachary Puckett, Yana MD

Farmington 4/13/2017 ONIK INTEGRATIVE MEDICINE Onik, Casey ONLINE RADIOLOGY MEDICAL GRP INC - reads for Eastern NMMC Ardakani, Navid Arefi Braunstein, John B Caverly, Jeffrey Clark Dew, Linda Louise Givens, Larry Gonzales-Villaverde, Alberto Harris, Gary Stuart 11/1/16 - license lapsed Jun, Aaron Hao Kuehn, Nicolaus Joseph Lis, Steven Thaddeus Lue, Jason McLellan, Garey L Mitchell, Richard A Patel, Atul J Piampiano, Peter Paul Reed, Peilin Chen Rippner, Robert Steven Roy, Dave A Salen, Samuel Sarfraz, Jamil Warren, James P Wayburn, Lawrence Gary Wedeen, Glenn P 11/1/16 - license lapsed Wells, David L Wolke, Ira Stephen ONRAD ICI 24/7 (was RADIOLOGY 24/7) Hudkins, Matthew Jain, Sanjay Tan, Kenneth Albuquerque 3/7/2017 OWEN, JOHN P PHD Albuquerque 5/18/2017 PADILLA, ELIGIO R PHD PATE, TONNA Inactive as of 6/2016 but not removed in 2016 X PITTS, MICHAEL PSYD inactive as of 9/28/16 but not removed in 2016 X PO Box 911576, Denver, CO 80291- 1576 & 2100 N Martin Luther King PLAINS REGIONAL MEDICAL CENTER Jr., Clovis, NM 88101 Consulting Psychological Services, 2/28/2017 PA Clovis 9/28/17 Poe, Chase M PhD dba Clovis Counseling Center

Rachel Trujillo Patient Care Coordinator Albuquerque 6/30/2017 PREMIER HEARING CENTER/ALBUQUERQUE 505-933-6315 (Rio Rancho Office) This was the owner, he has since retired and sold the Ballachanda, Bopanna business 6/12/17 removed from all locations Cannon, Michele Santa Fe 7/13/2017 PREMIER HEARING CENTER/SANTA FE Ballachanda, Bopanna Jackson, Catherine PREMIER HEARING CENTER/ LOS ALAMOS Ballachanda, Bopanna Jackson, Catherine PREMIER HEARING CENTER/RIO RANCHO Ballachanda, Bopanna Jackson, Catherine PREMIER HEARING CENTER /TAOS Ballachanda, Bopanna Jackson, Catherine RADIOLOGY ASSOCIATES OF ALBUQUERQUE -reads for Dan Trigg, Socorro General, Plains Regional, Espanola Reads for 200110A, 200225A, 201305A, 206001A, Hospital 221202C Bauman, Christopher Butler-Lewis, Renee Carroll, Stephen Centenera, Luis Vitaliano Collingwood, John Clair Fuentes-Bernardo, Daniel A. Hootman, Kent King, Jerry Lill, Duncan Logan, Jeremy Lopez, Kathleen Meek, Douglas Mena, Juan Carlos Montesinos, James Mullen, Sean Nisenbaum, Josef Patriquin, Lara Marie

Pfaff, Charles Phung, David Pluto, Charles Potts, Brian Rivera, Eugenio Jr. Rosenberg, Robert Rowley, Michael Ryan, Hillary Ryan, Patrick Schmit, Berndt Sellers, Randall Southam, Samuel L. Las Vegas 4/27/2017 RAINBOW RD THERAPIES, INC Simpson, M. Adelaide REED, RICHARD P PHD REHOBOTH-MCKINLEY CHRISTIAN HEALTHCARE Gallup 10/17/2016 SERVICES RODRIGUEZ, MICHAEL PHD Romero, Linda MD *New Provider as of 5/1/17 X RURAL RADIOLOGY ASSOCIATES LPPC -reads for Alta Vista, Gila Regional, and Holy Cross Hospitals Burke, James B. Gordon, Robert E. Johnson, Paul E. LaMotte, Gary A. Moses, Samuel Lee Orzel, Joseph A. Selzer, Peter M. Thomas, Lovick Whitaker, John Bacon

RURAL RADIOLOGY (was Taos Mountain Radiology) SAN JUAN REGIONAL MEDICAL CENTER uses Four Farmington 4/13/2017 Corners for XR Chavez, Denise Del Carmen, Villa Devitre, David Gabaldon, Jude Hoffman, Charles Jacob, Sodaran Kumar, Rahul Kumar, Ranjit Li, Ronald Alan Martin, Patrick 11/1/16 License lapsed Obisike, Uche Plagge, Amy Robinson, William Sandhu, Faraz Sharma, Vivek Vela-Sandoval, Carlos Weathers, Luther West, Michael B. Wilkins, Charles Wyndham, Christopher R. SANTA FE IMAGING LLC - reads for Christus St. Vincent's Santa Fe 1/19/2017 and Dr. Baten Santa Fe 5/30/2017 Beagle, Andrew N Burdick, Thomas R Gallegos, Margaret L Griste, John D Koolpe, Karen S Lee, Kevin D Lehman, Jonathan D Pruett, Wesley C Saini, Monica H Valencia, Regina A

SANTA FE RADIOLOGY read for St. Vincent's Hospital Beagle, Andrew N Burdick, Thomas R Gallegos, Margaret L Griste, John D Koolpe, Karen S Lee, Kevin D Lehman, Jonathan D Pruett, Wesley C Saini, Monica H Valencia, Regina A Silver City 3/14/2017 Las Cruces 8/7/17 SCHUTTE, JAMES PhD SF PULMONARY & CRITICAL CARE (interp St. Vincent's PFS) PO Box 843802, Dallas, TX 75284-3802 SIDD, RICHARD J MD 207 N Union, Ste. C, Roswell, NM 88201 TorC 5/22/2017 SIERRA VISTA HOSPITAL SIMPSON, MARK PSYD MAC LA DAC Socorro 3/31/2017 SOCORRO GENERAL HOSPITAL SOISSON, ELLEN L. PsyD

Sorenson Communications, Inc *New Provider - (sign language interp) as of 9/13/17 X Dawson, Lee Anna MacFarlane, James McCluskey, Paula Morris, Eldora Rivera, Amelia (Aimee) Sower, Monica Roswell 1/26/2017 SOUTHERN COUNSELING Southern, Douglas SOUTHWEST PEDIATRIC CARE Roque, Florence DNP, CPNP Las Cruces 3/16/2017 SOUTHWESTERN EYE CENTER Villalobos, Robert Santa Fe 5/30/2017 STEINMAN, WARREN PHD

Silver City 3/14/2017 STINAR, DONALD MD (Interprets PFTs for Gila Regional) PO Box 2857, Silver City, NM 88062-2857 1/19/2017 ST VINCENT'S HOSPITAL - uses Santa Fe Radiology for Santa Fe 2/9/17 XR and SF Pulmonary for PFT Las Cruces 3/15/2017 SUN VIEW IMAGING SERVICES Algeo, James H. Carlsbad 1/25/2017 TADDY FAMILY CLINIC Addy, Nii Tetteh

TRICORE REFERENCE LABORATORIES (all locations) ABQ-ANNA KASEMAN ABQ-ATRISCO ABQ-CEDAR ABQ-COORS ABQ-ENCINO ABQ-HARPER ABQ-ISLETA ABQ-MONTGOMERY ABQ-SAN MATEO BELEN CARLSBAD CLOVIS ESPANOLA LAS CRUCES LAS VEGAS LOS LUNAS RIO RANCHO RUIDOSO SANTA FE SILVER CITY TRUJILLO, MARTIN MD *Inactive as of 8/11/17 X UNION COUNTY GENERAL HOSPITAL - use High Plains Clayton 4/24/2017 Radiology for XR PO Box 489, Clayton, NM 88415 Andrew, John Aragon, Gary Archer, Branch Bentley, Gail Bickers, Gayle Brooks, Charles Chao, Stan Clark, Crandon Cook, Stanley Cox, Sammy Currie, Tully Daniel, Michael Elliott, Aaron France, Ratchnee

Goodell, Charles Haas, Stephan Hall, Michael Hashmi, Arouj Khanlian, Robert Khu, Richard Mehta, Rahul Nunn, Howard Pan, Paul Pinkston, Robert Radunsky, Daniel

Rosebrock, Richard Salem, Tarek Scalapino, Matthew Shah, Rakesh Speaks, Susan Uszynski, Martin Waugh, Kimberly Zarian, Lawrence Moved out of State - will be deactivated after all Albuquerque 3/7/2017 VALLE, VALERIE PSYD payments are processed. Espanola 5/30/2017 WARD, E MD

Las Cruces 9/15/2017 WorkMed Occupational Health *New Provider as of 8/9/17 X Gallardo, Benito MD Poncik, Wanda Jean CNP also licensed in Texas Corrales 5/19/2017 WYNNE, LOUIS PHD X RAY ASSOCIATES OF NEW MEXICO Albuquerque 6/1/2017 Bennett, Shelby Brooks, Gregory Norman Campbell, Karien MD Chaffey, Margaret MD Creel, Christopher Jeffrey MD Cronk, Roger L. DO Dautenhahn, Lawrence W. MD Depper, Mark H. MD Fillmore, David MD Gerety, Brigid Jellison, Brian MD Leung, Jimmy Ching Man MD Linver, Michael N. MD LoRusso, Alexander Patrick MD Lowry, James L. MD Martin, Thomas P. MD Matyas, Michael Alan MD Meyer, Kathleen MD Miller, Anthony James MD Miller, Kathryn MD Nenoff, Richard S MD Parker, Russell Kenneth MD Parker, Timothy W. MD Redd, Bernadette A. MD Rolle, Timothy Jon MD Stewart, John Martin MD Winterkorn, Keith G. MD FY 2017 NH DDS CE PROVIDERS

THE TOP FIVE CE PROVIDERS, BY DOLLAR AMOUNT, ARE DENOTED IN GREEN. ONSITE REVIEWS WERE COMPLETED FOR EACH OF THEM. NO CE PANELISTS WERE REMOVED FROM THE PANEL DUE TO INACTIVE LICENSE, SANCTION, OR CAUSE.

VN DR VNDR _2N VNDR _LOC_ D_ _PROF VNDR_LO ADDR VNDR_1ST_N NA _QUA VNDR_LOC_ADDR_LI C_ADDR_ VNDR_LOC_AD _STAT VNDR_LOC_ADDR_Z VNDR_SURNAME AME ME VNDR_SURNAME L VNDR_LOC_ADDR_LINE_1 NE_2 LINE_3 DR_CITY E IP HITCHCOCK CLINIC 149 EMERALD AUG JANET AUG OD OPHTHALMOLOGY STREET KEENE NH 03110-3611 BECOTTE DENNIS P BECOTTE PHD 142 MAIN ST STE 220 NASHUA NH 03060-2721

MT WASHINGTON VALLEY PSYCH BILDNER CHERYL BILDNER PHD SVC 81 WASHINGTON ST CONWAY NH 03818-6044

BLAKE TIMOTHY D BLAKE MD NASHUA EYE ASSOCIATES 5 COLISEUM AVE NASHUA NH 03063-3206

BROWN LAURA BROWN PSYD (b) (6) BERLIN NH 03570-4875

BURNETTE REXFORD F BURNETTE PHD 5 PLEASANT ST STE 1 BRISTOL NH 03222-3002

BURNS THOMAS F BURNS PHD (b) (6) DOVER NH 03820-0000

BYER JEFFREY B BYER MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713

194 PLEASANT ST CARWELL MARK A CARWELL MD CONCORD OTOLARYNGOLOGY PA STE 2 CONCORD NH 03301-2952

5 COLISEUM AVE STE COUTU RONALD B COUTU OD NASHUA EYE ASSOCIATES 101 NASHUA NH 03063-3292

N. CREST EX OFFICE 39 SIMON CRAIG MEGHAN A CRAIG PSYD MERRIMACK VALLEY COUNSELING PARK 2A ST NASHUA NH 03060-3046

194 PLEASANT ST DANIELL CHRISTOPHER H DANIELL MD CONCORD OTOLARYNGOLOGY PA STE 2 CONCORD NH 03301-2952

DARLING LAURA DARLING SLP KIDSPEAK LANGUAGE LE PO BOX 779 CONCORD NH 03302-0779

5 COLISEUM AVE STE DESAI-BARTOLI SONALEE DESAI-BARTOLI OD NASHUA EYE ASSOCIATES 101 NASHUA NH 03068-3292 DINAN WILLIAM A DINAN PHD (b) (6) CONCORD NH 03301-4803 DOWNEY PAUL DOWNEY PHD (b) (6) DURHAM NH 03824-0000

FRIEDRICH SHERIE L FRIEDRICH PSYD (b) (6) BROOKLINE NH 03033-0000 207 MEETING 207 MEETINGHOUSE HOUSE 03110- FUNG EVA FUNG OD MACKAY VISION CENTER RD BEDFORD NH 03110-6090 RD BEDFORD NH 6090

HEALTHYPARENT.CO GARBER BENJAMIN D GARBER PHD 400 AMHERST ST STE 407 M NASHUA NH 03063-4225

GARFINKLE ANDREW GARFINKLE MD LACONIA EYE ASSOCIATES 368 HOUNSELL AVE GILFORD NH 03249-6922

60 COMMERCIAL ST, GLASSMAN STUART J GLASSMAN MD GRANITE PHYSIATRY STE 303 CONCORD NH 03301-5096

EYESIGHT OPHTHALMIC SERVICES 267 ROUTE 108 STE SOMERSWORT GOLDBLATT WARREN S GOLDBLATT MD PA A H NH 03878-6512

GOURVITZ ROSS GOURVITZ PHD (b) (6) CONCORD NH 03301-2000

GRAF FRANK A GRAF MD 152 COURT ST STE 2 PORTSMOUTH NH 03801-4453

GRIFFIN ERICA L GRIFFIN OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

1 WASHINGTON ST GRIFFIN STEFANIE GRIFFIN PHD NE EVALUATION SPECIALISTS STE 443 DOVER NH 03820-3831

GUSTAVSON DARLENE GUSTAVSON PSYD 814 ELM ST STE 90A MANCHESTER NH 03101-2130

248 PLEASANT ST HALL BRADFORD S HALL OD CONCORD EYE CARE PC STE 1600 CONCORD NH 03301-2588

EYESIGHT OPHTHALMIC SERVICES 267 ROUTE 108 STE SOMERSWORT HASKELL SUSAN HASKELL OD PA A H NH 03878-6512

HESS ELIZABETH P HESS PHD (b) (6) BERLIN NH 03570-1017

HOLMES WILLIAM S HOLMES OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

HUTTON ANNA HUTTON PSYD PO BOX 250 GRANTHAM NH 03786-0250

JACKSON TRINA JACKSON PSYD (b) (6) SHELBURNE NH 03581-3101

DARTMOUTH HITCHCOCK 149 EMERALD JAEGER LAWRENCE J JAEGER MD OPHTHAL STREET KEENE NH 03110-3611 JARZOMBEK MICHAEL JARZOMBEK PSYD (b) (6) WEARE NH 03281-0000 KALPAKIAN BASILIO KALPAKIAN MD DARTMOUTH HITCHCOCK OPHTHAL 149 EMERALD STREET KEENE NH 03110-3611

KAMEN DAVID G KAMEN PHD 25 GREENVIEW DR APT 18 MANCHESTER NH 03102-8933

DARTMOUTH HITCHCOCK 1 MEDICAL CENTER KANAGALINGAM SIVASHAKTHI KANAGALINHAM MD MEDCIAL CENTER DR LEBANON NH 03756-0000

EYESIGHT OPHTHALMIC SERVICES 155 BORTHWICK KAVANAGH MARSHA C KAVANAGH OD PA AVE STE 200E PORTSMOUTH NH 03801-4184

KIRMES WILLIAM J KIRMES DO (b) (6) MANCHESTER NH 03104-6116

KORGESKI GREGORY KORGESKI PHD PO BOX 408 SAXON RIVER VT 05154-0408 LEE BRIAN LEE DO CONCORD OTOLARYNGOLOGY PA 194 PLEASANT ST STE 2 CONCORD NH 03301-2952

LEE RICHARD H LEE MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713

194 PLEASANT ST LOESER PETER LOESER MD CROSSROADS FAMILY MEDICINE STE 7 CONCORD NH 03301-2952

207 MEETINGHOUSE MACKAY DAVID MACKAY OD MACKAY VISION CENTER RD BEDFORD NH 03110-6090

EYESIGHT OPHTHALMIC SERVICES 267 ROUTE 108 STE SOMERSWORT MCLAUGHLIN LAUREN K MCLAUGHLIN OD PA A H NH 03878-6512

EYESIGHT OPHTHALMIC SERVICES MCLAUGHLIN MICHELLE L MCLAUGHLIN OD PA 192 WATER ST EXETER NH 03833-2416

SALE 03079- MEEHAN LAUREN K MEEHAN PSYD SALEM PSYCHOLOGICAL SERVICES 87 STILES RD STE 106 MNH 0000

MOQUIN PSYCHOLOGICAL MOQUIN DENISE MOQUIN PHD SERVICES 753 CHESTNUT ST MANCHESTER NH 03104-4614

MD MOSCOLA RITAMARIE MOSCOLA MPH (b) (6) BEDFORD NH 00000-3110

MURRAY JAMES MURRAY MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-0831

NEAL GEORGE B NEAL MD 18 CONSTITUTION DR UNIT 6 BEDFORD NH 03110-6076

EYESIGHT OPHTHALMIC SERVICES 267 ROUTE 108 STE SOMERSWORT PAC ADRIENNE PAC OD PA A H NH 03878-6512 87 STILES ROAD STE PIASCIK TIFFANY PIASCIK PSYD SALEM PSYCHOLOGICAL SERVICES 106 SALEM NH 03079-2899

HITCHCOCK CLINIC 149 EMERALD POLLACK DALE POLLACK OD OPHTHALMOLOGY STREET KEENE NH 03110-3611

NEW ENGLAND MEDICINE 120 ROUTE 10 POWELL STEVEN W POWELL MD COUNSELING ASSOC SOUTH GRANTHAM NH 03753-00000

194 PLEASANT ST REDDY ASHOK N REDDY MD CONCORD OTOLARYNGOLOGY PA STE 2 CONCORD NH 03301-2952

REGAN MAURICE REGAN PHD THE CONCORD CENTER 10 FERRY ST CONCORD NH 03301-0000 RIDDLE PATRICK J RIDDLE OD (b) (6) NASHUA NH 03063-3206

ROBBINS PHILLIP ROBBINS PHD 87 STILES RD STE 106 SALEM NH 03079-0000

RIDGEWOOD BLDG SPRINGFLD ROOT RICHARD ROOT EDD HOSP 20 RIDGEWOOD RD SPRINGFIELD VT 05156-2003

N CREST EX OFFICE 39 SIMON RUPPEL GEORGE RUPPEL PHD MERRIMACK VALLEY COUNSELING PARK 2A ST NASHUA NH 03060-3046

NORTHEAST EVALUATION 1 WASHINGTON ST SAMSON JAMES SAMSON OT SPECIALISTS STE 443 DOVER NH 03820-3831

SCOTT DOUGLAS SCOTT MD LACONIA EYE ASSOCIATES 368 HOUNSELL AVE GILFORD NH 03249-6922

865 S MAIN ST STE SIRONICH-KALKAN SILVIA SIRONCH-KALKAN MD THE DOCTORS OFFICE 103 MANCHESTER NH 03102-0000

SITKOWSKI SUZANNE SITKOWSKI PHD 511 ROUTE 132 NORWICH VT 05055-0000

248 PLEASANT ST SNEAD MAXWELL A SNEAD MD CONCORD EYE CARE PC STE 1600 CONCORD NH 03301-2586

6 TSIENNETO RD STE SPINDEL GERALD P SPINDEL OD SPINDEL EYE ASSOCIATES 101 DERRY NH 03038-1584

STERN JESSICA STERN PHD 169 PORTSMOUTH ST UNIT 192 CONCORD NH 03301-5844

STOCK MARJORIE STOCK MD ENT PHYSICIANS & SURGEONS PA 130 TARRYTOWN RD MANCHESTER NH 03103-2713 STRATTON KEVIN M STRATTON OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026

SU PRESCOTT ROBERT SU PRESCOTT PHD 20 LADD ST FL 4 PORTSMOUTH NH 03801-4087

SULLIVAN MAURA D SULLIVAN PSYD 15 N MAIN ST # 9 WOLFEBORO NH 03894-4485

5 COLISEUM AVE STE SUTHERLAND PHILIP L SUTHERLAND OD NASHUA EYE ASSOCIATES 101 NASHUA NH 03063-3292 SWINBURNE WILLIAM SWINBURNE PHD (b) (6) KEENE NH 03431-3409

248 PLEASANT ST SZAL MARK A SZAL MD CONCORD EYE CARE PC STE 1600 CONCORD NH 03301-2586

EYESIGHT OPHTHALMIC SERVICES 155 BORTHWICK SZYMD LUCIAN SZMYD JR OD PA AVE STE 200E PORTSMOUTH NH 03801-4184

TRICE JAMES M TRICE MD 21 S FRUIT ST, STE 30 CONCORD NH 03301-2453

NORTHEAST EVALUATION 1 WASHINGTON ST TRUDEL TINA TRUDEL PHD SPECIALISTS STE 443 DOVER NH 03820-3831

TSENG WINNIE TSENG OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON MJ 03561-4026

TUITE JOEL TUITE OD LITTLETON EYE CARE CTR 104 MEADOW ST LITTLETON NH 03561-4026 VALLERY SANDRA K VALLERY PHD (b) (6) EXETER NH 03833-2779

248 PLEASANT ST WASSERMAN PETER WASSERMAN MD CONCORD EYE CARE PC STE 1600 CONCORD NH 03301-2586

20 GROVE ST STE PETERBOROUG WEIL MICHAEL D WEIL PSYD PETERBOROUGH CLINICAL ASSOC 250 H NH 03458-1470

248 PLEASANT ST WHEELER MAYNARD B WHEELER MD CONCORD EYE CARE PC STE 1600 CONCORD NH 03301-2588

WILSON DONALD V WILSON MD HITCHCOCK CLINIC E.N.T. 580 COURT ST KEENE NH 03110-1718

765 S MAIN ST STE WINDLER WILLIAM N WINDLER MD THE DOCTORS OFFICE 103 MANCHESER NH 03102-0000

WINGATE CHARLES E WINGATE JR OD NASHUA EYE ASSOCIATES 5 COLISEUM AVE NASHUA NH 03063-3206 228 DANIEL WOLF RALPH R WOLF III MD HEALTH STOP OF SO NASHUA WEBSTER HWY NASHUA NH 03060-5537 WOODARD FREDERICK J WOODARD PHD (b) (6) MILFORD NH 03055-0000

228 DANIEL YAGER ROBERT D YAGER MD HEALTH STOP OF SO NASHUA WEBSTER HWY NASHUA NH 03060-5537 North Carolina FY 2017

Name Des Group Name Onsite Abel SLP, Cristy G Speechworks Therapy Services Abinanti SLP, Annie M G Pediatric Development Therapy Abramowitz PhD, Robert H I Robert H Abramowitz PhD Adair MD, Brian C G Graystone Ophthalmology Associates Adam MD, Lindsay G Coastal Carolina Eye Clinic Adams SLP, Monica L G TheraPeas 4/25/2017, Advanced Medical Consultants, GE Advanced Medical Consultants 5/16/2017 Akpaka PhD, Ernest Kalu I Ernest Kalu Akpaka MA 7/25/2017 Alamance Eye Center, GE Alamance Eye Center Alamance Regional Medical Center, M Alamance Regional Medical Center Albert PhD, Jerome B I Jerome B Albert PhD 4/25/2017 Aldinger MD, Kyle Anthony G Shelby Medical Associates Alesii PhD, LeKisha I Center for Health and Emotional Wellness Alleghany Memorial Hospital, M Alleghany Memorial Hospital Allen MD, Molly V G Coastal Carolina Eye Clinic Allen MD, Joseph G Graystone Ophthalmology Associates Allen SLP, Charlotte-Anne I Charlotte-Anne Allen SLP Allf MD, Bryan I Carolina Eye Care Anand MD, Dhanya G Med Plus NC Angel Medical Center, M Angel Medical Center Anthony PhD, Cheri R I Cheri R Anthony PhD Appollo PhD, Joseph P I Joseph P Appollo PhD Arrowood Jr MD, John Patterson G CarolinaEast Ear Nose & Throat Ashe Memorial Hosptial, M Ashe Memorial Hosptial Asheville Eye Associates, GE Asheville Eye Associates Asheville Head, Neck & Ear Surgeons, GE Asheville Head, Neck & Ear Surgeons Asheville Radiological Associates PA, M Asheville Radiological Associates PA Atienza MD, Romeo B I Romeo B Atienza MD 7/25/2017 Atkinson PsyD, Audrey I Balanced Mind Psychological Services Atkinson SLP, Keisha G Lenoir Memorial Hospital 10/13/2016, Bachara PhD, Gary H I Brentwood Psycho & Counseling 4/25/2017 Baggett MD, Henry Clifford G UNC Ear Nose and Throat Bahia MD, Surinder S G Advanced Medical Consultants Ball MD, Tracei I On Call Mobile Medical and Wellness Barnes MD, Tinka G Medical Support Associates Baron SLP, Nadege G Speech Tactics Beards SLP, Karen G Speechworks Therapy Services Beasley MD, Charles G Kinston Head & Neck Physicians & Surgeons Belhumeur MA, Jacqueline G Sylva Clinical Associates Bell MD, William L I FirstHealth Family Medicine Robbins 12/16/2016 Berg MD, Mary I The Pisgah Institute for Psycho & Education Berk MD, Carl G Pinehurst Surgical Clinic Bevis MA, Jay G Lifeworks Bhatti MD, Muhammad A I Wayne Family Medical Center 8/31/2017 Bing PhD, Richard Jefferson I Richard Jefferson Bing PhD Black MD, Kristin S G Gaston Family Health Services Black MD, Brendan G Olympus Health North Carolina Blatz PA, Kristin G Pinehurst Surgical Clinic Bloom MD, Mitchell G MDSI Physician Group Blue Ridge Cardiology & Internal Medicine, M Blue Ridge Cardiology & Internal Medicine Blue Ridge ENT Allergy & Facial Plastic, GE Blue Ridge ENT Allergy & Facial Plastic Blue Ridge Radiology Associates, M Blue Ridge Radiology Associates Blue Ridge Regional Hospital, M Blue Ridge Regional Hospital Boan FNP, Ardelius G Merolina Medical Clinic Boice Willis Clinic, M Boice Willis Immediate Care Clinic Boliek SLP, Haden P G Pediatric Development Therapy Bolz MD, Everett G Tri State Occupational Medicine Bones MD, Brian G Med Plus NC Bones MD, Victoria G Olympus Health North Carolina Bonfield MD, Kenneth G Morganton Eye Physicians Boone SLP, Aliya I A to Z Speech Therapy Boutilier MD, Susan G ECU Physicians Neurology Bowers SLP, Bradley I Speech Pathology & Audiology Services of Robeson Bowers SLP, Linda S G WCU Speech & Hearing Boyce MD, Stephen E G Raleigh Capitol Ear, Nose, & Throat Bradford MD, Daniel William I Daniel William Bradford MD Brafford SLP, Kasten G Tidewater Therapy for Children Brahmbhatt MD, Bharat G CE Provider Services, LLC Bramble MA, J Michael I J Michael Bramble Branch MD, James D I James D Branch MD Branner MD, William G Charlotte Ophthalmology Clinic Brannon PhD, Julia M I Julia M Brannon PhD Brantley III PsyD, David I David Brantley III PsyD Brasington MD, Chadwick G Alamance Eye Center Brechtelsbauer MD, Paul G Eastern Carolina ENT Head & Neck Surgery Brewer MA, Lisa I Lisa Brewer MA Briere DO, Misha G CE Provider Services, LLC Britt SLP, Wendy I Confident Solutions LLC Brna Jr. MD, Theodore George I Bailey Family Practice Center Brodish MD, Brian G Eastern Carolina ENT Head & Neck Surgery Broman-Fulks PhD, Joshua Jefferson I Joshua Jefferson Broman-Fulks PhD 10/21/2016 Brown MD, Sandra G Cabarrus Eye Center Brown MD, Jonisha R G Olympus Health North Carolina Brown MD, Laura D G Raleigh Capitol Ear, Nose, & Throat Brown SLP, Erin E G Therapy Playground Buglisi MD, Joseph I Buglisi Eye Care Burgess Jr PsyD, Elwood Johnson G The Neuropsychology Consultants Burgess MD, Stephen B G Tri State Occupational Medicine Burnett PhD, Edmund C I Carriage House Associates Cabarrus Eye Center, GE Cabarrus Eye Center Caceres MD, Marco G CE Provider Services, LLC Cain MD, Wilbert I Wilbert Cain MD Calderon MD, Boris G Med Plus NC Caldwell Memorial Hospital, M Caldwell Memorial Hospital Cameron MD, Harold G Coastal Eye Clinic Camilleri SLP, Kathryn C G Complete Speech Therapy & Wellness Campbell PhD, Richard C I Richard C Campbell PhD 11/21/2016 Cape Fear Eye Associates, GE Cape Fear Eye Associates Carbonell MD, Antonio G SXR Medical Evaluations Cardiology Associates of the Carolinas, GE Cardiology Associates of the Carolinas Carolina East Medical Center, M Carolina East Medical Center Carolina Imaging Center, M Carolina Imaging of Fayetteville Carolina Psychology Group, GE Carolina Psychology Group Carolina Radiology Consultants, M Carolina Radiology Consultants Carolina Surgery and Cancer Center PLLC, M Carolina Surgery and Cancer Center PLLC Carolina Vision Center, GE Carolina Vision Center Carolina West Radiology PA, M Carolina West Radiology PA CarolinaEast Diagnostic Center, M CarolinaEast Diagnostic Center CarolinaEast Ear Nose & Throat, GE CarolinaEast Ear Nose & Throat Carolinas HealthCare System Anson, M Carolinas Anson Healthcare Inc Carolinas HealthCare System Cleveland, M Cleveland Regional Medical Center Carolinas Medical Center Lincoln, M Carolinas Medical Center Lincoln Carolinas Medical Center Union, M Carolinas Medical Center Union Carraro MD, Stevie N G CE Provider Services, LLC Carter SLP, Jennifer L G Speechcenter Carteret Clinic for Adolescents & Children, GE Carteret Clinic for Adolescents & Children Carteret County General Hopsital, M Carteret County General Hopsital Casterlow MA, Ronnie D I Ronnie Dean Casterlow MA Catawba Radiological Associates, M Catawba Radiological Associates Catawba Valley Medical Center, M Catawba Valley Medical Center Catawba Valley Psychological Associates, GE Catawba Valley Psychological Associates 9/6/2017 CE Provider Services, LLC, GE CE Provider Services, LLC 9/9/2017 Central Carolina Hospital, M Central Carolina Hospital Ceraulo MD, Anthony G Olympus Health North Carolina Chadbourn Family Practice Center, GE Chadbourn Family Practice Center Chae MD, Phillip G CE Provider Services, LLC Chance MD, James Kenneth G Coastal Eye Clinic Chang MD, Richard I G Graystone Ophthalmology Associates Charles A Cannon Jr Memorial Hospital, M Charles A Cannon Jr Memorial Hospital Charles MD, Cathy-Anne G CE Provider Services, LLC Charlotte EENT Associates PA, GE Charlotte EENT Associates PA Charlotte Medical Clinic, GE Charlotte Medical Clinic Charlotte Ophthalmology Clinic, GE Charlotte Ophthalmology Clinic Charlotte Radiology, M Charlotte Radiology Christianson MD, Dana J G Looking Glass Eye Center CHS Blue Ridge Morganton, M CHS Blue Ridge Morganton CHS Blue Ridge Valdese, M CHS Blue Ridge Valdese CHS Northeast, M CHS Northeast Clark MD, Lee I Medical Eye Associates PA Clark MD, William G I Wake Forest Urgent Care 2/16/2017 Clark SLP, Bridget G Speechworks Therapy Services Clarkson MD, Mark W G Raleigh Capitol Ear, Nose, & Throat Clay Jr MD, Hank G Hank Clay Jr MD Clay SLP, Rebekkah K I R Kelley Clay Cleveland County Health Care System, M Cleveland County Health Care System Clinton X-Ray Associates, M Clinton X-Ray Associates Coastal Carolina Eye Clinic, GE Coastal Carolina Eye Clinic Coastal Eye Center, GE Coastal Eye Center Coastal Eye Clinic, GE Coastal Eye Clinic Coastal Internal Medicine, GE Coastal Internal Medicine 7/21/2017 Coastal Radiology, M Coastal Radiology Coastal Surgical Specialists, M Coastal Surgical Specialists Coffey PhD, Jerry G Sylva Clinical Associates Coleman MA, David I David Coleman MA Collier MD, John R G ENT Carolina Collins MA, Clyde A G Southeastern Psychological Services Columbus Regional Healthcare System, M Columbus Regional Healthcare System Complete Speech Therapy & Wellness, GE Complete Speech Therapy & Wellness Cone Health Medical Group Heartcare, M Cone Health Medical Group Heartcare Connect Center for Wellness, GE Connect Center for Wellness 7/27/2017 Cornerstone Ear, Nose & Throat, GE Cornerstone Ear, Nose & Throat Correa SLP, Nancy J G Speechcenter Corrie SLP, Sarah I Pediatric Speech Solutions Coury DO, Jeffrey G I Coastal Carolina Ear, Nose & Throat Cox MD, Stanley G Pinehurst Surgical Clinic Cox PhD, Keith I Keith Cox PhD Craig DO, Christopher G CE Provider Services, LLC Crandall MD, James D G Asheville Eye Associates Crane Ed.D, Edward I Edward Crane Ed.D Crane PsyD, Karen I Karen Crane PsyD Craven SLP, Caitlin A G Speechcenter Crawford MD, Bronson G CE Provider Services, LLC Crawford MD, Michael D G UNC Ear Nose and Throat Crichlow MD, Brian I Brian Crichlow MD Currin MA, Heather I Heather Currin MA Daniel MA, Rebecca G Sylva Clinical Associates Daniels-Davis SLP, Chanda S I KidSpeak Inc Darji MD, Sunny G CE Provider Services, LLC Davant MD, Charles I Blowing Rock Medical Clinic Davidson Eye Associates, GE Davidson Eye Associates Davis MD, Teneisha C G Advanced Medical Consultants Davis MD, Andrew G Morganton Eye Physicians Davis PhD, Cheryl I Cheryl Davis PhD 8/2/2017 Davis SLP, M. Patricia G WCU Speech & Hearing Dawson MD, Sean G Olympus Health North Carolina Dearinger DO, Michael R G Olympus Health North Carolina Deem MD, Mark G SXR Medical Evaluations Delaney Radiology Group, M Delaney Radiology Group Dempsey SLP, Hannah G Speechcenter Denny PhD, Ellen I Triangle Behavioral Health DeWilde MD, Kristen G CE Provider Services, LLC Dimuzio Jr DO, James I Coastal Carolina Ear, Nose & Throat Dingeldein MD, Steven A G Alamance Eye Center Dinkins SLP, Brittany G Speechworks Therapy Services Dorton MD, Leighanne G Charlotte EENT Associates PA Downing PsyD, Lori J I Downing Psychological 5/4/2017 Downs MD, Jairon G Olympus Health North Carolina Doyle MD, Kevin M G Raleigh Capitol Ear, Nose, & Throat Dubiel MD, Barbara I Barbara Dubiel MD Duke Cardiology of Raleigh, M Private Diagnostic Clinic Duke Eye Center, M Duke Eye Center Duke Radiology of Raleigh, M Duke Radiology of Raleigh Duke Raleigh Hospital, M Duke Raleigh Hospital Duke Regional Hospital, M Duke Regional Hospital Dunmire SLP, Sherry G Kommunikate Plus Dunn SLP, Beverly I Beverly L Dunn SLP Dunn SLP, Lucy C G Speechcenter Durham Diagnostic Imaging LLC, M Durham Diagnostic Imaging Durham Radiology Associates Inc, M Durham Radiology Associates Inc Durland Jr MD, William Frederick G Raleigh Capitol Ear, Nose, & Throat Durrett MD, Samuel G CE Provider Services, LLC Duszlak MD, Carla G MDSI Physician Group Dye PhD, Shiahna G Connect Center for Wellness Dziadziola Jr. MD, James Kenneth G Northeast ENT Center Earwood SLP, Kendra L I Speech Connections Eason MD, Ernest B I Dr Ernest B Easton 3/21/2017 East Carolina Neurology, GE ECU Physicians Neurology East Carolina University, M East Carolina University Eastern Carolina ENT Head & Neck Surgery, GE Eastern Carolina ENT Head & Neck Surgery Eastern Radiologists, M Eastern Radiologists Eastern Radiologists Inc, M Eastern Radiologists Inc Edsell SLP, Janet G Speechworks Therapy Services Edwin MD, Micah G SXR Medical Evaluations Eichenbaum MD, Daniel M I Daniel M Eichenbaum MD Ellebracht SLP, Susan G Tidewater Therapy for Children Emekauwa MD, Chikanele G Med Plus NC ENT Carolina, GE ENT Carolina Epps Jr MD, Earl I Earl J Epps Jr MD Esame MD, Alice G Med Plus NC Eskander MD, Essam S G Chadbourn Family Practice Center Espiritu MD, Maria G Med Plus NC Evans III PhD, Frank Barton I Frank B Evans PhD Fannin Regional Hospital, M Fannin Regional Hospital Farhad DO, Bamdad G Advanced Medical Consultants Farhad MD, Bamdad G Med Plus NC Farmer PhD, C Craig I C Craig Farmer PhD Ferguson MD, Steven W I Eastern Carolina Geriatric Assoc and Family Care C Ferriss SLP, Beth I Speech Unlimited Fertil SLP, Cavin G Speechworks Therapy Services Fields MD, Mark Lewis I Mark Lewis Fields MD 3/21/2017 Finnegan MD, Lindsey G CE Provider Services, LLC Fiore PhD, Michael Francis I Michael Fiore PhD Firsthealth Cardiology of Laurinburg, GE Firsthealth Cardiology Firsthealth Cardiology of Rockingham, GE Firsthealth Cardiology FirstHealth of the Carolinas, M FirstHealth of the Carolinas Fishel OD PA, Jennifer R I Jennifer Fishel OD PA Fitzgerald MA, Jeffrey R G Lifeworks Fitzpatrick SLP, Joy G Therapy Playground Fleming MD, Duard G ECU Physicians Neurology Fletcher Hospital Inc, M Fletcher Hospital Inc Flinn SLP, Jamie G Speak Advantage Flores MD, Agustin Gilbert R G MDSI Physician Group Folds MD, William I Club Haven Family Practice Footman SLP, Chantanna G Speechworks Therapy Services Forero MD, Edward G SXR Medical Evaluations Fowler PsyD, Sean I Piedmont Counseling and Developmental Group Fox PsyD, Lisa G The Neuropsychology Consultants Fox SLP, Elizabeth G TheraPeas Frank MD, Harrison I Frank Institute for Health and Wellness Franklin MD, Quentin G Coastal Eye Center Franklin SLP, Montoya G Speech Tactics Frere MD, Robert Carroll G ECU Physicians Neurology Friedland MD, Beth R G Park Ophthamology Friedman SLP, Tia G Tidewater Therapy for Children Fuller MD, Lance G Yelverton's Enrichment Services, Inc Garner SLP, Laurie G Speechworks Therapy Services Gartlan DO, William A G Med Plus NC Gaslin MD, Michael G ENT Carolina Gaston Eye Associates, GE Gaston Eye Associates Gaston Family Health Services, GE Gaston Family Health Services Gaston Memorial Hosptial Inc, M Gaston Memorial Hosptial Inc Gaston Radiology PA, M Gaston Radiology PA Gebrail MD, Ayman G Coastal Internal Medicine Gencarella SLP, Laura E G Speech Tactics Gerber MD, Matthew J G Raleigh Capitol Ear, Nose, & Throat Gibson MA, Barbara I Barbara Gibson MA 7/6/2017 Gillespie MD, Richard R G Cornerstone Ear, Nose & Throat Girmay MD, Aregai G Gaston Family Health Services Gish MD, Larry Morgan I Rowan Diagnostics Gliga MD, Diana G CE Provider Services, LLC Gloor DO, Richard I Richard Gloor DO Godfrey SLP, Natalie R G Speechcenter Gold MD, Steven R G Charlotte EENT Associates PA Goldberg MD, Eric I Tidewater Neurologists Gombas DO, Michelle M G CE Provider Services, LLC Goncharow DO, William G G CE Provider Services, LLC Goodwin-Baldwin PsyD, Tanya I Goodwin Psychological Services Grady MD, Richard Dwight G CarolinaEast Ear Nose & Throat Grafenberg MD, Matthew G Pinehurst Surgical Clinic Granite Falls Primary Care, GE Cornerstone Healthcare Gray PsyD, Samuel B G Carolina Psychology Group Graystone Ophthalmology Associates, GE Graystone Ophthalmology Associates Greene SLP, Michaela G Speechcenter Greensboro Ophthalmology Associates, GE Greensboro Ophthalmology Associates Greensboro Radiology, M Greensboro Radiology PA Greensboro Radiology PA, M Greensboro Radiology PA Gregson SLP, Cara G Speechcenter Grewal MD, Harkiran G Med Plus NC Groat Eyecare Associates, GE Groat Eyecare Associates Groat MD, Richard S G Groat Eyecare Associates Groat MD, Christopher L G Groat Eyecare Associates Groat MD, Robert L G Groat Eyecare Associates Grover PsyD, Brianna G The Neuropsychology Consultants Guttler MD, Sanford G Cornerstone Healthcare Halford SLP, Amy G Speechworks Therapy Services Halifax Medical Specialists, M Halifax Medical Specialists Halifax Regional Medical Center Inc, M Halifax Regional Medical Center Inc Hall SLP, Brenda I Brenda Hall SLP Hamm OD, Cara G Coastal Eye Clinic Hammond Assessment Services, GE Hammond Assessment Services Hammond PhD, Joseph K G Hammond Assessment Services Hammond SLP, Ellie I Hammond Assessment Services Hancock PhD, Russell C I Russell C Hancock PhD Hank Clay Jr MD, GE Hank Clay Jr MD Hannah MD, Frank G Morganton Eye Physicians Hardy MD, John G ECU Physicians Neurology Hargrove MD, Roderick N G Graystone Ophthalmology Associates Harhara MD, Haleema G CE Provider Services, LLC Harnett Health System Inc, M Harnett Health System Inc Harper MD, Nathan G CE Provider Services, LLC Harrelson MD, Bryan H G MDSI Physician Group Harris Jr MD, James Woodrow G Graystone Ophthalmology Associates Harris MD, Gregory Stuart G Advanced Medical Consultants Harris Regional Hospital Inc, M Harris Regional Hospital Inc Harris SLP, Stacy G Speechworks Therapy Services Harris SLP, Meka G Speechworks Therapy Services Hatfield PhD, Phillip B I Phillip B Hatfield PhD 12/15/2016 Hawkins MD, Thomas G Davidson Eye Associates Haywood Medical Imaging, M Haywood Medical Imaging Haywood Regional Medical Center, M Haywood Regional Medical Center Hefner SLP, Rachel Helms G Therapy Playground Heim SLP, Lindsay M G WCU Speech & Hearing Hemphill MD, Irmaine G Olympus Health North Carolina Henderson County Hospital Corp, M Henderson County Hospital Corp Hendersonville Radiological Consultatns, M Hendersonville Radiological Consultants Hendrix MD, Robert G UNC Ear Nose and Throat Herek SLP, Kasha G Tidewater Therapy for Children Hester MA, Rebecca G Sylva Clinical Associates Heyder MD, Albrecht I Atlantic Pulmonary Associates High Point Regional Hospital, M High Point Regional Hospital Highsmith-Rainey Specialty Hospital, M Highsmith-Rainey Memorial Hospital Hildreth MS, Jeffrey I Jeffrey Hildreth MS 11/9/2016 Hill SLP, Tina G Pitt County Memorial Hospital Hillman MD, Vincent Francis G Huntersville Family Practice 8/24/2017 Hinson PhD, Renee C G Trinity Center Hollander MD, Edward G Greensboro Ophthalmology Associates Holmes SLP, Michelle A G Therapy Playground Honeycutt SLP, Michelle E G Kommunikate Plus Hoogerman PhD, Dennis I Dennis Hoogerman PhD Hooker MD, Neema G Olympus Health North Carolina Horizon Surgical Associates, M Horizon Surgical Associates Horsley MA, Elizabeth I Ross Psychological Services Hosea MD, Robert G Kinston Head & Neck Physicians & Surgeons Howell MD, Tamieka G CE Provider Services, LLC Hugh Chatham Memorial Hospital, M Hugh Chatham Memorial Hospital Hughey MD, Rebekah G Med Plus NC Humphrey MD, Jordan C G CE Provider Services, LLC Huneycutt MD, Bouasy Ly G Olympus Health North Carolina Hunt PsyD, J Craig I J Craig Hunt PsyD 8/11/2017 Huntersville Family Practice, GE Huntersville Family Practice Hutchens SLP, Patricia G Pediatric Development Therapy Igboekwe MD, Vincent G Advanced Medical Consultants Ipock SLP, Crystal T G Lenoir Memorial Hospital Iredell Memorial Hospital, M Iredell Memorial Hospital Iredell Radiology Associates, M Iredell Radiology Associates Izquierdo DO, Manuel G CE Provider Services, LLC J Arthur Dosher Memorial Hospital, M J Arthur Dosher Memorial Hospital Jacksonville Diagnostic Imaging LLC, M Jacksonville Diagnostic Imaging LLC James PsyD, Amy I Amy D James PsyD James SLP, Deborah C I Southern Therapy Services James-Nzambele MD, Shana D G Gaston Family Health Services Jamison MD, Cornelius G MDSI Physician Group Jamison PsyD, Deanna Lynn G The Neuropsychology Consultants Jarvis MD, Bennie G UNC Ear Nose and Throat Jean-Gracia MD, Jolene G MDSI Physician Group Jeffrey FNP, Benjamin G Yelverton's Enrichment Services, Inc Jerrell SLP, Kai G Speechworks Therapy Services Jiang MD, Bo G Olympus Health North Carolina Jindal MD, Vinod I New Century Opthalmology Group Johnson MA, David C I Pineview Psyc Services Inc 1/23/2017 Johnson MD, Gregory James G Coastal Carolina Eye Clinic Johnson MD, James C I James C Johnson MD Johnson PhD, Amy Fowler I Amy Johnson PhD 8/2/2017 Johnson PhD, Amy L I The Gathering Space Johnston DO, Timothy L I Timothy L Johnston DO Johnston Memorial Hospital, M Johnston Memorial Hospital Jones MD, Karen G Olympus Health North Carolina Jones SLP, Jerry L I JCS Rehabilitation & Wellness 6/7/2017 Jones SLP, Alina G Speechworks Therapy Services Jones SLP, Holly G Speechworks Therapy Services Jones SLP, Kerri G Tidewater Therapy for Children Jordan SLP, Sharon C G Speech Tactics Joslyn MD, Ann K G Graystone Ophthalmology Associates Judkins DO, Kyle G Med Plus NC Julich MD, Brian G CE Provider Services, LLC Kantesaria MD, Atul N I Atul N Kanesaria MD 7/29/2017 Kapoor MD, Sushma S G Med Plus NC Kath MD, Philip D G Morganton Eye Physicians Kauff MA, Elizabeth Ann I Cleveland Psychological Services 2/16/2017 Kelleher SLP, Kate G WCU Speech & Hearing Kellermann FNP, Kendra G Coastal Internal Medicine Kern SLP, Christie I Saltwater Speech Therapy Kerr MD, Kirsten S G Cornerstone Healthcare Keshinro MD, Munirat G CE Provider Services, LLC Kesler MD, James L G Coastal Carolina Eye Clinic Khurana MD, Neera I Neera Khurana MD Killian MD, Frank G Asheville Eye Associates Kilpatrick MD, Jefferson G Pinehurst Surgical Clinic Kincaid MS, Rebecca J I Rebecca J Kincaid MS 8/11/2017 King MD, Bradley G Alamance Eye Center King MD, Walter L I Dr Walter L King King PhD, Anne Ashley I Anne Ashley King PhD 3/21/2017 King PsyD, Michele I King Neuropsychological Services 6/10/2017 Kinston Head & Neck Physicians, GE Kinston Head & Neck Physicians & Surgeons Kirby Jr MA, Johnny G Catawba Valley Psychological Associates Kiser SLP, Lawson G Lincoln Speech Services Knowles-Jonas MD, Lynde G CE Provider Services, LLC Kohli MD, Asha K I Family Psychiatric Clinic Kommunikate Plus, GE Kommunikate Plus Krause MD, Robert A I Robert A Krause MD Krauss SLP, Jeffrey G Speechworks Therapy Services Krych PhD, Raymond E G Sylva Clinical Associates Kukreja MD, Neeta I South Charlotte Pediatrics PLLC Kuranga MD, Abraham G Olympus Health North Carolina Kyerematen MD, Gabriel G Advanced Medical Consultants Laboratory Corportaion of America, M Laboratory Corportaion of America Lacroix, Christopher I Viva Med PLLC Lacroix MD, Christopher G Advanced Medical Consultants Ladson-Abrom SLP, Lakeeta G Complete Speech Therapy & Wellness Lam OD, Duy G Cape Fear Eye Associates Landau MD, Steven G MDSI Physician Group Langston MD, Dennis G CE Provider Services, LLC Lanier PhD, Joseph G PsycLinc Lavoie PA, Bryan G Coastal Internal Medicine Lawal MD, Olujide G Firsthealth Cardiology Le MD, Tin T I Med Stat Centre Lenoir Memorial Hospital, M Lenoir Memorial Hospital Levitt MD, Stephen R I Stephen R Levitt MD Levy MD, Frederic G ENT Carolina Lewis MA, Mary Frances G Southeastern Psychological Services Lexington Memorial Hospital Inc, M Lexington Memorial Hospital Inc Lifeworks, GE Lifeworks 6/19/2017 Lincoln Speech Services, GE Lincoln Speech Services 6/19/2017 Lindsay MD, Carlotta M G Advanced Medical Consultants Link PhD, William G Southeastern Psychological Services Locklear MD, Aaron G Advanced Medical Consultants Locklear SLP, Ursulla I Simply Speaking Speech Therapy Long PsyD, Lisa G MDSI Physician Group Looking Glass Eye Center, GE Looking Glass Eye Center Lopez MS, Alexander I Alexander Lopez MS 12/15/2016 Lorence MA, Jeffrey I Jeffrey Lorence MA 8/24/2017 Love PsyD, Christopher G PsycLinc Loveless MD, Howard W G CarolinaEast Ear Nose & Throat LoVerde MD, Zachary J G MDSI Physician Group Lowery MD, John G Gaston Eye Associates Lowry MD, Jadene I Jadene Lowry MD 1/23/2017 Lowry MD, Jonathan G Morganton Eye Physicians Lucas MA, Gayla R I Gayla R Lucas MA Lucas PhD, Bert I Lucas Psychological Services 6/6/2017 Ludwigsen SLP, Kelly Rice G Therapy Playground Lukacs DO, Nicholas G Cornerstone Ear, Nose & Throat Lund MD, Michael G Gaston Eye Associates Lutz MD, Cordula G Med Plus NC Lyles MD, Graham W G Greensboro Ophthalmology Associates Madujibeya SLP, Belinda I BJM Speech Language Therapy & Rehabilitation Maginn PhD, Vincent J I Vincent J Maginn PhD Mann MD, David B G Blue Ridge ENT Allergy & Facial Plastic Mansour MA, Donna A I Donna A Mansour MA 6/27/2017 Marcellino MD, Amanda Jo G Olympus Health North Carolina Marchese MD, Diana G Olympus Health North Carolina Marcus PsyD, Karen R I Karen R Marcus PsyD Mariah Parham Medical Center LLC, M Mariah Parham Hospital Inc Mark Beattie MD, M Hidden Valley Medical Center Martinat SLP, Martha G Speechworks Therapy Services Masere MD, Constant G CE Provider Services, LLC Matt PhD, Allyson I Allyson Matt PhD Maxwell PhD, David I Ascent Psychological Services McCarter SLP, Lara G Tidewater Therapy for Children McClelland MD, William Alfred G Cornerstone Ear, Nose & Throat McCullen MD, Bobby G Gaston Eye Associates McDaniel PhD, William F I William F McDaniel PhD McDowell FNP, Mary G Shelby Medical Associates McFadden SLP, Marcella G TheraPeas McGaffagan MA, Patricia G The Neuropsychology Consultants McGilberry MS, Janice G Connect Center for Wellness McGuirt MD, Wyman T G Pinehurst Surgical Clinic McKinnon MD, Steve I McKinnon Eye Clinic PA McKnight MD, Thomas Alexander G Med Plus NC McKnight MD, Thomas A G Olympus Health North Carolina MCM Pediatric and Adolescent Home Practice, GE MCM Pediatric and Adolescent Home Practice McNeil SLP, Cynthia G Speechworks Therapy Services McNeill FPN, Charlotte G MCM Pediatric and Adolescent Home Practice McNulty PhD, Walter I Walter McNulty PhD 7/1/2017, MDSI Physician Group, GE MDSI Physician Group 8/12/2017 Mecklenburg X-Ray Associates PA, M Mecklenburg X-Ray Associates PA Med Plus NC, GE Med Plus NC 7/20/2017 MedFirst Medical Center, GE MedFirst Medical Center 8/16/2017 Medford PsyD, Jessica I Medford Psychological Services Medical Support Associates, GE Medical Support Associates 7/1/2017 Meekins MD, Bettina G Coastal Eye Clinic Melson Mock MD, Michelle I Michelle Melson Mock MD Meltzer MD, Morton I Morton Meltzer MD 8/3/2017 Melvin Kearney SLP, Amanda I Amanda Melvin SLP 8/7/2017 Melvin MD, Frank G Asheville Head, Neck & Ear Surgeons Merghani MD, Mohamed G MCM Pediatric and Adolescent Home Practice Merolina Medical Clinic, GE Merolina Medical Clinic Meymandi MD, PhD DLFAPA, Assad I Assad Meymandi MD PhD Mid-Carolina Radiological Associates PA, M Mid-Carolina Radiological Associates PA Middleton SLP, Taylar G TheraPeas Midgley MD, John C I Dunn Internal Medicine 7/20/2017 Mikac DO, Ryan G Med Plus NC Miller MA, Jerry L I Genesis Counseling Mission Hospital Inc, M Mission Hospital Inc Mission Imaging Services, M Mission Imaging Services Monk SLP, Chareen R I Chareen R Monk Moody SLP, Tammie G Lincoln Speech Services Moore MD, Robert Brian G Asheville Head, Neck & Ear Surgeons Moorehead MD, Katharine S G Carteret Clinic for Adolescents & Children Morehead Memorial Hospital, M Morehead Memorial Hospital Morelli SLP, Karla G Speech Tactics Morganton Eye Physicians, GE Morganton Eye Physicians Morris MD, Peter G Advanced Medical Consultants Morris MD, Peter Delaney G MDSI Physician Group Morrison SLP, Haywood J G Speechworks Therapy Services Morton PhD, Todd L I Todd L Morton PhD Morton SLP, Jeanine I Theraplay Moshay SLP, Beverly I Beverly R Moshay SLP Moss MA, Tamela I Moss Psychological Assessments Mount PsyD, David I David Mount PsyD Mouser MD, Timothy I Southeastern Eye Care Mozie MD, Benjamin I Shalom Medical 12/8/2016 Mullins MD, Jessica G CE Provider Services, LLC Munn III MD, Alber R I Capital Eye Center Munoz MD, Melchor Hernan G Olympus Health North Carolina Murphy Medical Center Inc, M Murphy Medical Center Inc Murphy SLP, Kathy O G Therapy Playground Myers MD, Brian G Med Plus NC Myers SLP, Letishe G Complete Speech Therapy & Wellness Nabors MD, Lawrence Howard I L Howard Nabors MD Nash Hospital Inc, M Nash Hospital Inc Nash X-ray Associates PA, M Nash X-ray Associates PA National Radiology Consultants, M National Radiology Consultants Nelson MD, James G Olympus Health North Carolina New Hanover Regional Medical Center, M Cleveland County Health Care System Newton PsyD, Rosalyn G PsycLinc Ngo MD, Corazon I Dr Corazon Ngo 12/8/2016 Nguyen MD, Hao G Advanced Medical Consultants Nguyen MD, Hien N G Olympus Health North Carolina Northeast ENT Center, GE Northeast ENT Center Northern Hospital of Surry County, M Northern Hospital of Surry County Novant Health Brunswick Medical Center, M Brunswick Community Hospital LLC Novant Health Imaging Maplewood, M Novant Health Imaging Maplewood Novant Health Imaging Museum, M Novant Health Imaging Museum Novant Health Imaging Triad, M Novant Health Imaging Triad Novant Health Imaging University, M Novant Health Imaging University Ocloo MD, Shirley D G Gaston Family Health Services Ocloo MD, Shirley G Medical Support Associates Odeke MD, Sylvester G CE Provider Services, LLC Ogu MD, Dontus G Merolina Medical Clinic Okeiyi MD, Benson G Med Plus NC Olympus Health North Carolina, GE Olympus Health North Carolina 8/12/2017 Onslow Memorial Hospital, M Onslow Memorial Hospital Orrison MD, William G Morganton Eye Physicians O'Shaughnessy SLP, Sallie L G Speechcenter Osman MD, Ibrahim G Advanced Medical Consultants Ouano MD, Dean G Coastal Eye Clinic Oursler III MD, Ralph E G Graystone Ophthalmology Associates Owen MD, James C I James C Owen MD Pabst SLP, Mary G Pitt County Memorial Hospital Packer SLP, Yalonda G Speak Advantage Palanza MA, Michael A I Michael A Palanza MA Pardoll PsyD, Mindy E I Mindy E Pardoll PsyD Park Ophthamology, GE Park Ophthamology Patel MD, Maharshi G Advanced Medical Consultants Patel MD, Mishal G Advanced Medical Consultants Patel PA, Khushboo G MedFirst Medical Center Patterson MD, Dwayne G Tri State Occupational Medicine Patterson PhD, Nona Louise I Nona Louise Patterson PhD Paulson SLP, Leah G Tidewater Therapy for Children Pediatric Development Therapy, GE Pediatric Development Therapy Pender Memorial Hospital Inc, M Pender Memorial Hospital Inc Person County Memorial Hospital Inc, M Person County Memorial Hospital Inc Person Health Cardiology, M Person Health Cardiology/Person Physicians Practic Pettit FNP, Carrie G Yelverton's Enrichment Services, Inc Phillips MD, Brandon G Carolina Vision Center Physicians East, M Physicians East Pinehurst Neurology, GE Pinehurst Neurology Pinehurst Radiology Associates, M Pinehurst Radiology Associates Pinehurst Surgical Clinic, GE Pinehurst Surgical Clinic Pitt County Memorial Hospital, M Vidant Medical Center Pitt County Memorial Hospital - SLP, GE Pitt County Memorial Hospital Plemmons MA, Mitchell G Catawba Valley Psychological Associates Poole PhD, Teresa A. I Teresa A. Poole PhD Porfilio MD, William L G Alamance Eye Center Powell MD, Eugene Neal I Carolina Orthopaedic Surgery Associates Powell SLP, Denise G Speechworks Therapy Services Presbyterian Hospital Inc, M Presbyterian Hospital Inc Price Jr, MD, Donald Lowell G ECU Physicians Neurology Price PhD, John Ryan I Carolina Child Psychology Providence Imaging Center Inc, M Providence Imaging Center PsycLinc, GE PsycLinc Puente PhD, Antonio E I Antonio E Puente PhD Quest Diagnostics Inc, M Quest Diagnostics Inc Quinn MD, Robert Patel I Quinn Ear, Nose & Throat Quinn PhD, Patrick C I Behavioral Health and Consulting Psychology 6/12/2017 Qureshi MD, Ayyaz M I Dr Ayyaz M Qureshi 1/31/2017 Radson MS, Robert D I Radson & Strayer Psychological Associates 2/16/2017 Raleigh Capitol Ear, Nose, & Throat, GE Raleigh Capitol Ear, Nose, & Throat Raleigh Radiology Cedarhurst, M Raleigh Radiology Cedarhurst Raleigh Radiology LLC, M Raleigh Radiology LLC Randolph Hospital Inc, M Randolph Hospital Inc Ransak MD, Amy G Olympus Health North Carolina Rapchik MD, Joel I Joel Rapchik MD Raynor MD, Leighton G Morganton Eye Physicians Reavis PhD, Mary Rachel Rebecca G PsycLinc 5/30/2017 Reiber MD, Mark Edwin G ENT Carolina Reihl PhD, Kristina I Reihl Psychological Services PLLC Rene MD, Marshel G Tri State Occupational Medicine Rex Hospital Inc, M Rex Hospital Inc Rex Pulmonary Specialists, M Rex Pulmonary Specialists Rex Surgical Specialists, M Rex Surgical Specialists Reynolds II MD, Eugene G Gaston Family Health Services Rheney Jr, MD, Theodore G Asheville Head, Neck & Ear Surgeons Rhoads MD, Edward J I Edward J Rhoads MD Ricci PhD, Christopher M I Christopher M Ricci PhD Richardson FNP, David G Coastal Internal Medicine Richardson MA, Jan H G Lifeworks Richardson MD, Kendra G Olympus Health North Carolina Richman MD, Jonathan G Pinehurst Neurology Ricketson PsyD, Jake E I High Point Psyc Associates 4/6/2017 Riddick MD, Gwendolyn L G CE Provider Services, LLC Ritterspach PsyD, Chad Christopher I Valued Living Roberti SLP, Graciela I Bilingual Therapy & Language Services 8/23/2017 Rogers SLP, Sherry G Kommunikate Plus Rogers SLP, Jean I Three Cs Speech Therapy Services PLLC Rollinson EdD, Allison G RTC Psychological Associates Romine OD, Van S G Alamance Eye Center Rose SLP, Sonya F G Kommunikate Plus Rose SLP, Amy J G WCU Speech & Hearing Rosenthal-Dibb SLP, Jennifer L G Therapy Playground Rothrock MA, Heather I Heather Rothrock MA Rowan Regional Medical Center, M Rowan Regional Medical Center Rowe MD, Loreli G Carteret Clinic for Adolescents & Children Roy MD, Perry G Olympus Health North Carolina Royster SLP, Eden G TheraPeas RTC Psychological Associates, GE RTC Psychological Associates Sabiston MD, Walter G Kinston Head & Neck Physicians & Surgeons Sadoff PhD, Jennifer L I Lake Norman Psychological Services 8/7/2017 Salisbury MD, James G Morganton Eye Physicians Samia MD, Mark A G MedFirst Medical Center Sampson Regional Medical Center, M Sampson Regional Medical Center Sanders MD, Stephen B I Dr Stephen B Sanders 4/6/2017 Satterly MD, R Alan G Eastern Carolina ENT Head & Neck Surgery Scaglione MD, Jamie G Northeast ENT Center Scanlon SLP, Amanda W I Amanda W Scanlon SLP Scheinder MD, Inaam I Schneider Medical Group, PA 7/19/2017 Schell MD, Scott T I Scott T Schell MD Schneider MD, Lori I Harborview Plastic Surg/Neurology Schneidmiller PhD, Sara I Sara Schneidmiller PhD 7/19/2017 Sciarra DO, Marc G Med Plus NC Scotland Cardiology, M Scotland Cardiology Scotland Memorial Hospital, M Scotland Memorial Hospital Scott SLP, Pamela G Pitt County Memorial Hospital Seagle MD, Roger I Cardiology Associates of the Carolinas 5/30/2017 Seales MD, David M I Northwest Neurology Sentara Albemarle Medical Center, M Albemarle Hospital Authority Setty MD, Janaki Ram G Advanced Medical Consultants Sewell MD, Kia G CE Provider Services, LLC Shannon-Kirby MA, Roberta A G Catawba Valley Psychological Associates Sharon Jr MD, Elliott G SXR Medical Evaluations Shaw PhD, Elizabeth I Elizabeth Shaw PhD Sheffield SLP, Elizabeth G Tidewater Therapy for Children Shelby Radiological Associates PA, M Shelby Radiological Associates PA Shelton PsyD, Robert Ray I Robert Ray Shelton PsyD Sherrod SLP, Faith G Speechworks Therapy Services Shukla MD, Vikram R I Dr Vikram R Shukla Shuping SLP, Rebekah G Complete Speech Therapy & Wellness Shuping SLP, Rebekah Ann I Professional Speech Services Sibille MD, Joshua A G Med Plus NC Silver PhD, Rueben J I Rueben J Silver PhD Silverstein MD, Michael G CE Provider Services, LLC Sinclair PsyD, Andrea G Catawba Valley Psychological Associates Singh MD, Jasvinder P I Albemarle Pulmonary Med Assoc Sizemore MA, Nancy I All Care Psychological Associates Sizemore SLP, Jessica G Speechcenter Slawek MD, David F I David F Slawek MD Slutzky PsyD, Howard I Safe Harbor Psychological Services Slyman MD, James G Davidson Eye Associates Smeltz Zapata MA, Christine I Christine Smeltz-Zapata MA Smith MD, John R I John R Smith MD Smith MD, Rondell A G MDSI Physician Group Smith SLP, Jana G Lincoln Speech Services Snyder MD, Robert G Pinehurst Neurology Sobanjo MD, Sybil O G Med Plus NC Solanki PsyD, Nina G MDSI Physician Group Solomon MD, Bruce G Pinehurst Neurology Solstas Lab Partners, M Solstas Lab Partners Solutions of Hickory, GE Solutions of Hickory Song MD, Ronnie G Med Plus NC Souffrant MD, Edmire G Med Plus NC Southeastern Psychological Services, GE Southeastern Psychological Services 1/23/2017 Southeastern Radiology Associates, M Southeastern Radiology Associates Southeastern Regional Medical Center, M Southeastern Regional Medical Center Southern Medical Group, GE Southern Medical Group 8/5/2017 Spaulding PhD, Christopher I Christopher Spaulding PhD Speak Advantage, GE Speak Advantage Spectrum Medical Group, M Spectrum Medical Group Speech Tactics, GE Speech Tactics Speechcenter, GE Speechcenter Speechworks Therapy Services, GE Speechworks Therapy Services Spruill SLP, Nicole I Spruill's Speech and Language Services Stahl MD, Jennifer G CE Provider Services, LLC Stallings MD, Leonard G CE Provider Services, LLC Stamp MD, Ian Patrick I Shelby Internal Medicine Stanly County Imaging PLLC, M Stanly County Imaging PLLC Stanly Regional Medical Center, M Stanly Regional Medical Center Staten DO, Elaine Alice I Scotland Memorial Hospital Statesville HMA Inc, M Statesville HMA Inc Steeb SLP, Amanda G Lincoln Speech Services Steinmuller MD, Warren J I Dr Warren J Steinmuller Stella OD, David I David Stella OD Stephenson MD, Shelby G Cape Fear Eye Associates Stitt Jr MD, Van J G Medical Support Associates Stone FNP, Amanda Jo G Coastal Internal Medicine Sundar MD, Veerappan I Veerappan Sundar MD Sutton PhD, Griffin I Griffin Sutton PhD Swaim SLP, Amy J G Swaim Therapies Swaim Therapies, GE Swaim Therapies Swaminathan MD, Viswanathan I East Coast Psychiatric Services SXR Medical Evaluations, GE SXR Medical Evaluations 7/21/2017 Sylva Clinical Associates, GE Sylva Clinical Associates Tabet MD, Munther I Munther Tabet MD Tamba DO, Ismael G Advanced Medical Consultants Taylor MA, Rebecca Marie G RTC Psychological Associates Tennessee Interventional and Imaging Associates, M Tennessee Interventional and Imaging Associates Teoh MD, Su Wooi I Su Wooi Teoh MD Tessnear PhD, Eddie S I Coastal Psychological Associates The McDowell Hospital, M McDowell Hospital The Moses H Cone Memorial Hospital, M Annie Penn Hospital The Neuropsychology Consultants, GE The Neuropsychology Consultants 12/8/2016 The Outer Banks Hospital Inc, M The Outer Banks Hospital Inc TheraPeas, GE TheraPeas Therapy Playground, GE Therapy Playground Thompson MD, Caroline G Advanced Medical Consultants Thornton MA, Sally Jane I Magnolia Center for Counseling 9/6/2017 Tidewater Therapy for Children, GE Tidewater Therapy for Children Tighe NP, Connie G Pinehurst Surgical Clinic Tonn MS, Henry I Henry Tonn MS 11/21/2016 Total Radiology Solutions, M Total Radiology Solutions Transylvania Community Hospital, M Transylvania Community Hospital Tri State Occupational Medicine, GE Tri State Occupational Medicine 7/19/2017 Triad Radiology Associates, M Triad Radiology Associates Tring DO, Vi Song G Med Plus NC Trinity Center, GE Trinity Center Trivette SLP, Laura G WCU Speech & Hearing Troxler PhD, Susie Ozetta I Susie Ozetta Troxler PhD Tucker SLP, Cheryl G Speechworks Therapy Services Tunau MD, Habiba G MDSI Physician Group Uddstrom SLP, Sarah E G Speech Tactics Umesi MD, Joseph G Advanced Medical Consultants UNC Ear Nose and Throat at Nash, GE UNC Ear Nose and Throat at Nash UNC Ear Nose and Throat at Roanoke Rapids, GE UNC Ear Nose and Throat at Roanoke Rapids UNC Hospital Hearing and Voice Center, M UNC Hospital Hearing and Voice Center Underwood MD, Gregory Alan G Charlotte Medical Clinic Union General Hospital, M Union General Hospital Valley Radiology, M Valley Radiology Valley Radiology Associates PA, M Valley Radiology Associates PA Van Der Vaart, Robert G Coastal Carolina Eye Clinic Vaziri MD, Boyd G Charlotte Ophthalmology Clinic Vecchio-Russell MS, Kathryn G The Neuropsychology Consultants Verdi MD, Vincent James G Coastal Eye Center Verma SLP, Madhu G Tidewater Therapy for Children Vidant Bertie Hospital, M Vidant Bertie Hospital Vidant Chowan Hospital, M Vidant Chowan Hospital Vidant Duplin Hospital, M Vidant Duplin Hospital Vidant Hospital, M Vidant Beaufort Hospital Vidant Roanoke-Chowan Hospital, M Vidant Roanoke-Chowan Hospital Villacorte MD, Lizette G Med Plus NC Villanueva MD, David G Olympus Health North Carolina Villarosa PhD, Gregory A I Gregory A Villarosa PhD 6/21/2017 Vin-Parikh MD, Anita P G Alamance Eye Center Vockel SLP, Giovanna G Swaim Therapies Volatile MD, Katherine G Looking Glass Eye Center Wake Forest Univ Health Sciences, M Baptist Hospital Wake Radiology Consultants PA, M Wake Radiology Consultants PA Wake Radiology Diagnostic Imaging, M Wake Radiology Diagnostic Imaging Wake Radiology Diagnostic Imaging Inc, M Wake Radiology Diagnostic Imaging Walker PhD, Jessica A I Jessica Ann Walker PhD Wall MD, Antoinette I Antoinette Wall MD Wall MD, Stephen I Haywood Ped & Adolscence Med Warner MS, Terry I Terry Warner MS Warnken MS, John K I John K Warnken MS 8/7/2017 Washington County Hospital, M Washington County Hospital Watauga Medical Center Inc, M Watauga Medical Center Inc Watauga Radiological Services PA, M Watauga Radiological Services PA Watkins PA, Veronica G MedFirst Medical Center Watson MD, Samantha G Coastal Carolina Eye Clinic Wayne Memorial Hospital, M Wayne Memorial Hospital Wayne Radiologists PA, M Wayne Radiologists PA WCU Speech & Hearing, GE WCU Speech & Hearing Weatherford MA, Rita G PsycLinc Webb SLP, Janet G Tidewater Therapy for Children Weeks MA, Ashly T G The Neuropsychology Consultants Welborne MD, Barry M G Charlotte Medical Clinic Welcker PhD, Joy I JLF Services 4/6/2017 Westfall MA, Alexandria I Alexandria Westfall MA 6/21/2017 Whitaker MD, Albert I Gastonia Family Practice Whitehead PhD, Courtney G MDSI Physician Group Wiggins Jr MD, Robert G Asheville Eye Associates Wilkes Radiology PA, M Wilkes Radiology PA Williams MD, Randal J G Graystone Ophthalmology Associates Williams MD, Thomas R G Graystone Ophthalmology Associates Williams SLP, Ebony G Speak Advantage Willis MD, Larry F G Morganton Eye Physicians Willis SLP, Cynthia I Perfectly Speaking Wilmed Healthcare, M Wilmed Healthcare Wilmington Health Associates Medical Clinic, M Wilmington Health Associates Medical Clinic Wilson MA, Jana I NC Center for Counseling & Psychological Services Wilson Mem Hospital Community Radiology, M Wilson Mem Hospital Community Radiology Wilson SLP, Stacy I Dogwood Developmental Therapy Wims SLP, Wanda G Speechworks Therapy Services Winford MD, Tyler G Med Plus NC Winston Salem Cardiology Associates, M Winston Salem Cardiology Associates Wood MD, Frank I Frank Wood MD WRMC Hospital Operating Corp, M WRMC Hospital Operating Corp Yadkin River Radiology PA, M Yadkin River Radiology PA Yelverton's Enrichment Services, Inc, GE Yelverton's Enrichment Services, Inc York SLP, Faeben G Complete Speech Therapy & Wellness Young MD, Leo K G MDSI Physician Group Zafar MD, Muhammad S G Southern Medical Group Zahner MA, Courtney G Trinity Center Zechman MD, James I Allergey & Asthma Clinic of New Bern Zelenak MD, Jozef I Zelenak Psychiatry PLLC Zoda SLP, Stephanie G TheraPeas Zorko MD, Bryan G CE Provider Services, LLC

Removed from panel in 2016 - Removal for Cause Reason Onsite Morris Britt PhD 6/12/2017 11/9/2016, Kumar Internal Medicine (Kamlesh Kumar MD, 5/4/2017, Satish Kumar MD) (b) (6) 8/7/2017 Dean MD, Joan I - signifies indiviudal provider performing examinations on their own G - significes individual provider performing examinations with a group GE - indicates a group M - Studies only provider (i.e. hosptials, labs, radiologists)

Volume and Key providers in blue (by group) Top 5 providers in Red (by group) New York FY 2017

CASE WHEN MA_ADDRLN_1 IS NULL THEN KEY CE_PROVIDER_NM MA_CITY MA_STATE SA_ADDRLN_1 ELSE MA_ADDRLN_1 END INDUSTRIAL MEDICINE ASSOCIATES 3250 WESTCHESTER AVE, STE 120 BRONX NY INDUSTRIAL MEDICINE ASSOCIATES 186 JORALEMON STREET 5TH FLOOR BROOKLYN NY INDUSTRIAL MEDICINE ASSOCS, PC 699 HERTEL AVE STE 355 BUFFALO NY INDUSTRIAL MEDICINE ASSOC PC 42 BROADWAY 19TH FLOOR NEW YORK NY INDUSTRIAL MEDICINE ASSOC, PC 214 ALEXANDER ST STE 200 ROCHESTER NY INDUSTRIAL MEDICINE ASSOC PC 1762 CENTRAL AVE ALBANY NY INDUSTRIAL MEDICINE ASSOC PC 518 JAMES STREET SYRACUSE NY INDUSTRIAL MEDICINE ASSOCIATES 80-02 KEW GARDENS RD KEW GARDENS NY INDUSTRIAL MEDICINE ASSOCIATES 1690 WASHINGTON AVE BOHEMIA NY INDUSTRIAL MEDICAL ASSOC PC 301 MANCHESTER MILL CENTER POUGHKEEPSIE NY INDUSTRIAL MEDICINE ASSOC PC 280 N. CENTRAL AVE, STE 115 HARTSDALE NY INDUSTRIAL MEDICINE ASSOC PC 679 MAIN STREET WESTOVER NY INDUSTRIAL MEDICINE ASSOCS, PC 430 COURT STREET UTICA NY INDUSTRIAL MEDICINE ASSOCIATES 250 FULTON AVE HEMPSTEAD NY BATH BEACH MEDICAL PC 2071 CLOVE ROAD STE A STATEN ISLAND NY INDUSTRIAL MEDICINE ASSOCS PC 31 SHERMAN ST STE 1300 JAMESTOWN NY BUFFALO HEARING & SPEECH CTR 6941 ELAINE DRIVE SUITE 4 NIAGARA FALLS NY GLENS FALLS HOSPITAL 102 PARK ST., SUITE B-2 GLENS FALLS NY OSIKA & SCARANO PSYCH SVC PC 5 PINE STREET GLENS FALLS NY LAUREANO CRISTINA M. (b) (6) BRONX NY FROMER, MARK D MDPC 550 PARK AVENUE NEW YORK NY FROMER, MARK D MDPC MED CORP 550 PARK AVENUE NEW YORK NY SCHIFFMAN, RICHARD G. MD (b) (6) BROOKLYN NY STURM, JOSEPH MD (b) (6) Woodmere NY WEINBERG, JERRY C MD PENNSPORT MALL PHILADELPHIA PA EYES ON ROCHESTER 1157 FAIRPORT ROAD SUITE 201 FAIRPORT NY ENT & ALLERGY ASSOCIATES 75 SOUTH BROADWAY, 3RD FLOOR WHITE PLAINS NY ENT AND ALLERGY ASSOCIATES,LLP 1200 WATERS PLACE/STE 110 BRONX NY EYECARE OF CNY 2901 COURT STREET SYRACUSE NY EAST END EYE ASSOCIATES 251 EAST OAKLAND AVENUE PORT JEFFERSON NY BERNARD, PETER J. MD (b) (6) NEW YORK NY CAPITAL REG OTO HEAD & NECK GP 6 EXECUTIVE PARK DRIVE #C ALBANY NY CORTLAND ENT PC 64 POMEROY STREET CORTLAND NY HERSH, SHELDON MD (b) (6) FOREST HILLS NY KAKANI, RAJESH MD ADVANCED OTOLARYNGOLOGY PC GARDEN CITY NY RATHI, SEEMA MD (b) (6) YONKERS NY

CAYUGA COMP PSYCH SERVICES, PC TIOGA PLACE ON ITHACA COMMONS ITHACA NY TITONE, FRANK R. MD (b) (6) JACKSON HEIGHTS NY KUPERBERG, ABRAHAM PHD (b) (6) FAIR LAWN NJ ZOLTAN, ROBERT MD (b) (6) FOREST HILLS NY YELENA GLOBINA MD 50 COURT STREET SUITE 508A BROOKLYN NY GRIFFIN PHD, EUGENA PO BOX 80327 BROOKLYN NY CHENG, ANDREW MD (b) (6) NEW YORK NY REHABILITATION TODAY SERVICES 784 MAIN STREET OLEAN NY ROBATEAU, LISA CCC-SLP 78 RYERSON ST, GROUND FLOOR BROOKLYN NY KATZ, SUSAN 240 EAST 82nd ST APT 4E NEW YORK CITY NY OMNI EYE SURGERY 406 15TH STREET BROOKLYN NY FROMER, MARK D MDPC 109-33 71ST ROAD STE 2C FOREST HILLS NY THOMAS, KELLY PSYD 150 WEST 225TH STREET APT 29F BRONX NY KELLER, PETER MD (b) (6) BRONX NY HAHN, JUNG LEE MD (b) (6) STATEN ISLAND NY SHARON JOLLY & ASSOCIATES 101 STAGE ROAD MONROE NY MILESTONE PSYCHIATRIC SVCS PC 15 PLEASANT STREET HORNELL NY NO COUNTRY FAM PHYSICIANS PC 309 COUNTY RTE 47-STE 1 SARANAC LAKE NY RUBIN, CHARLES MD (b) (6) JOHNSON CITY NY BERNIER JR., JOSEPH PHD 5 PINE WEST PLAZA-SUITE 508 ALBANY NY LIOTTA RICHARD PHD PO BOX 229 RAINBOW LAKE NY ANTWINE-BOYD, NAFEESAH 453 MACON STREET APT A1 BROOKLYN NY

BRONX PSYCHOLOGY SERVICES,PLLC 27 Melrose Ave Mount Vernon NY BONANNO, PHILIP MD 70 GLEN STREET ROOM 380 GLEN COVE NY GURTOVY, MARK MD 2150 CENTER AVE STE 1-B FORT LEE NJ THOMAS BEHAVIORAL HEALTH INC 150 WEST 225TH STREET APT 29F BRONX NY BERNSTEIN SPEECH-LANGUAGE PLLC 61-21 215TH STREET BAYSIDE NY NORTH COUNTRY KIDS 22 New York Road PLATTSBURGH NY YORKTOWN BERNSTEIN, MARTIN MD (b) (6) HEIGHTS NY PICHE JACQUES MD PO BOX 1732 PLATTSBURGH NY HESS, DAVID MD CARDIO CONSULT OF LONG ISLAND NEW HYDE PARK NY GLENS FALLS HOSPITAL QUEENSBURY NY JAMESTOWN OPTOMETRIC GROUP DBA/SPECTRUM EYE CARE JAMESTOWN NY LEXINGTON HEARING & SPEECH CTR 25-26 75TH STREET JACKSON HEIGHTS NY OLAJIDE, BOLANLE ABIMBOLA MD (b) (6) BALDWIN NY LONG ISLAND E.N.T.ASSOCS PC 100 EAST SUNRISE HWY STE A LINDENHURST NY MORGAN,RITA M.S. (b) (6) POMONA NY MYERS, BONNIE CCC/SLP (b) (6) Plattsburgh NY GALETTE, FRITZ PHD (b) (6) STATEN ISLAND NY DURANTE, ANTHONY J. MD (b) (6) MINEOLA NY BRONX PARK SURGICAL OF SBH ATTN: (b) (6) BRONX NY YU PHD, WEIZHEN 76-58 174th STREET FRESH MEADOWS NY FREEDMAN, BLIMIE MS CCC SLP (b) (6) BROOKLYN NY THOMAS MYERS PHD 25306 WEST END DR 2ND FL LITTLE NECK NY DR.MATTHEW D'ORTONA, PSY.D (b) (6) ELMIRA NY BUMATAY,JOSEPH MD (b) (6) FLUSHING NY PATHAK, KAMAL D. MD (b) (6) CORNING NY BENJAMIN, ANAT MD (b) (6) NEW HYDE PARK NY SHPITALNIK, VILOR MD 1723 E. 12TH ST.2ND FLR BROOKLYN NY THOMAS PSYD, KELLY 150 WEST 225TH ST APT 29F BRONX NY SCHLEUDERER, CLAUDE PHD (b) (6) KINGSTON NY PEARL, ALDEN J. MD 34 PLAZA STREET EAST STE 106 BROOKLYN NY LAB CORP OF AMERICA PO BOX 12140 BURLINGTON NC SAFO MARGARET MD (b) (6) FAR ROCKAWAY NY JOLLY, SHARON 77 QUAKER AVE UNIT 202 CORNWALL NY LAUREANO, CHRISTINA M (b) (6) BRONX NY PHELPS, STEPHEN W. PHD (b) (6) LAURENS NY ABRAMSON, VICTOR MD 532 NEPTUNE AVE ROOM 203 BROOKLYN NY TSUI, ELLEN C PHD 837 58th STREET 3rd FL BROOKLYN NY ABRAMSON, ALLA MD (b) (6) BROOKLYN NY NEWMAN, STEVEN MD (b) (6) BROOKLYN NY HERSH, SHELDON MD (b) (6) WOODMERE NY SHAPIRO, ARNOLD L. MD 2448 ROUTE 54A PENN YAN NY RUBIN PSYCHOLOGICAL SVCS PC 320 ROBINSON AVE STE 201A NEWBURGH NY BERTI, MARTHA SLP PC (b) (6) NORTHPORT NY SHPITALNIK, VILOR MD 1723 E.12TH ST. 2ND FLR BROOKLYN NY BRENNAN, HOPE SLP (b) (6) SAUGERTIES NY ADIRONDACK MEDICAL CENTER LAKE COLBY DRIVE SARANAC LAKE NY ENG NANCY PHD. SP/L 9 MOTT STREET SUITE 200 NEW YORK NY WAKSLAK, HARRY PHD (b) (6) LONG BEACH NY BAKST, YAEL CCC/SLP (b) (6) FLUSHING NY RODRIGUEZ-HERMAN, LINDA PHD LRH SPEECH PATHOLOGY INC WANTAGH NY ST JOHNS RIVERSIDE HOSPITAL 967 NORTH BROADWAY YONKERS NY KIM, DAMIAN MD (b) (6) FLUSHING NY BEDARD, JOEL MD (b) (6) HEMPSTEAD NY NEERUKONDA, SAMPATH MD (b) (6) HORNELL NY SMUGLIN, CLAUDIA MD (b) (6) REGO PARK NY NEYSTAT, MARINA MD WEILL CORNELL MED COLL ALUMNI NEW YORK NY SPITZER, JEFFREY MD (b) (6) BROOKLYN NY SUNY/FREDONIA THOMPSON HALL/ROOM W123 FREDONIA NY LAGO, JESUS A. MD (b) (6) PURCHASE NY ALBANY EYE PHYSICIAN & SURGEON 930 ALBANY SHAKER ROAD LATHAM NY DEMARCO, LAURA PHD (b) (6) HORNELL NY OSIKA & SCARANO PSYCH SVCS 8 Williams Street Elizabethtown NY LONG ISLAND E.N.T. ASSOC. PC 875 OLD COUNTRY ROAD SUITE 200 PLAINVIEW NY FEINER, LEONARD MD (b) (6) LAWRENCE NY

HIGHLAND OPHTHALMOLOGY ASSOC 140 EXECUTIVE DR NEW WINDSOR NY CULLINAN, THOMAS PHD 2190 BOSTON RD STE 1A BRONX NY DR ALLEN MARK HOCHBERG PHD (b) (6) VESTAL NY ESHKENAZI, AZARIAH MD (b) (6) FOREST HILLS NY STATEN ISLAND UNIVERSITY HOSP 475 SEAVIEW AVENUE STATEN ISLAND NY ACM MEDICAL LABORATORIES INC 160 ELM GROVE PARK ROCHESTER NY Grand Total MA_ZIP5 O/V Count Amount Certified for Payment 10461 27,726 $3,490,289.07 11201 19,211 $2,714,695.00 14207 15,376 $2,280,437.30 10004 15,137 $2,083,966.01 14607 13,711 $2,025,987.70 12205 11,900 $1,657,610.45 13203 12,141 $1,547,596.28 11415 10,788 $1,481,319.12 11716 9,592 $1,348,701.50 12603 8,397 $1,165,576.51 10530 6,704 $1,001,939.35 13790 7,403 $939,816.94 13502 5,353 $808,162.03 11550 5,343 $792,428.69 10304 3,776 $597,704.83 14701 2,488 $364,232.59 14304 952 $214,850.40 12801 807 $162,307.15 12801 776 $106,898.42 10465 289 $61,955.82 10021 298 $51,107.00 10065 263 $45,104.50 11235 173 $44,430.75 11598 232 $39,788.00 19148 170 $29,155.00 14450 141 $24,181.50 10601 88 $22,638.00 10465 88 $22,638.00 13208 125 $21,437.50 11777 119 $20,408.50 10128 76 $19,691.88 12203 76 $19,477.50 13045 68 $17,493.00 11375 66 $16,978.50 11530 65 $16,721.25 10701 92 $15,778.00

14850 109 $15,509.04 11372 89 $15,263.50 7410 94 $14,976.07 11375 85 $14,577.50 11201 112 $14,406.56 11208 101 $13,046.74 10013 47 $12,090.75 14760 73 $11,925.73 11205 56 $11,919.53 10028 55 $11,790.90 11215 66 $11,319.00 11375 65 $11,147.50 10463 83 $10,676.29 10461 34 $9,371.42 10305 70 $9,004.10 10950 39 $8,360.82 14843 48 $8,305.72 12983 57 $7,932.16 13790 46 $7,889.00 12205 34 $7,625.79 12976 57 $7,497.28 11233 56 $7,203.28

10552 31 $6,713.34 11542 36 $6,174.00 7024 46 $5,916.98 10463 44 $5,659.72 11364 25 $5,359.50 12903 25 $5,359.50

10598 30 $5,145.00 12901 20 $5,145.00 11040 13 $5,126.75 12804 21 $4,501.98 14701 26 $4,459.00 11370 16 $4,183.38 11510 32 $4,116.16 11757 16 $4,116.00 10970 19 $4,073.22 12901 18 $3,858.84 10305 24 $3,724.10 11501 15 $3,675.00 10457 21 $3,601.50 11366 27 $3,473.01 11210 16 $3,430.08 11362 22 $3,322.98 14901 22 $2,829.86 11366 10 $2,572.50 14830 10 $2,572.50 11040 13 $2,229.50 11229 17 $2,186.71 10463 17 $2,186.71 12401 16 $2,145.29 11238 8 $2,058.00 27216 120 $1,957.19 11691 15 $1,929.45 12518 9 $1,929.42 10465 9 $1,929.42 13796 12 $1,855.93 11224 14 $1,800.82 11220 11 $1,561.93 11224 12 $1,543.56 11209 12 $1,543.56 11598 6 $1,543.50 14527 9 $1,543.50 12550 8 $1,506.78 11768 7 $1,500.66 11229 11 $1,414.93 12477 6 $1,286.28 12983 8 $1,190.72 10013 5 $1,071.90 11561 7 $900.41 11367 4 $857.52 11793 4 $857.52 10701 3 $826.89 11354 6 $771.78 11550 5 $643.15 14843 5 $643.15 11374 5 $643.15 10065 4 $514.52 11215 3 $514.50 14063 2 $428.76 10577 3 $385.89 12110 2 $343.00 14843 2 $257.26 12932 2 $257.26 11803 1 $257.25 11559 1 $171.50

12553 1 $171.50 10462 1 $128.63 13850 1 $128.63 11375 1 $128.63 10305 2 $18.90 14624 1 $10.13 182,482 $25,672,228.31 New York FY 2017

Provider Name Street Address City State BERNIER JR., JOSEPH PHD 5 PINE WEST PLAZA-SUITE 508 ALBANY NY CAPITAL REG OTO HEAD & NECK GP 6 EXECUTIVE PARK DRIVE #C ALBANY NY OLAJIDE, BOLANLE ABIMBOLA MD (b) (6) BALDWIN NY BERNSTEIN SPEECH-LANGUAGE PLLC (b) (6) BAYSIDE NY BRONX PARK SURGICAL OF SBH ATTN: (b) (6) BRONX NY CULLINAN, THOMAS PHD 2190 BOSTON RD STE 1A BRONX NY ENT AND ALLERGY ASSOCIATES,LLP 1200 WATERS PLACE/STE 110 BRONX NY KELLER, PETER MD (b) (6) BRONX NY LAUREANO CRISTINA M. (b) (6) BRONX NY THOMAS BEHAVIORAL HEALTH INC 150 WEST 225TH STREET APT 29F BRONX NY ABRAMSON, ALLA MD 532 NEPTUNE AVE BROOKLYN NY ABRAMSON, VICTOR MD 532 NEPTUNE AVE ROOM 203 BROOKLYN NY ANTWINE-BOYD, NAFEESAH 453 MACON STREET APT A1 BROOKLYN NY FREEDMAN, BLIMIE MS CCC SLP 1285 EAST 34TH STREET BROOKLYN NY GRIFFIN PHD, EUGENA PO BOX 80327 BROOKLYN NY NEWMAN, STEVEN MD (b) (6) BROOKLYN NY OMNI EYE SURGERY 406 15TH STREET BROOKLYN NY PEARL, ALDEN J. MD 34 PLAZA STREET EAST STE 106 BROOKLYN NY ROBATEAU, LISA CCC-SLP 78 RYERSON ST, GROUND FLOOR BROOKLYN NY SCHIFFMAN, RICHARD G. MD (b) (6) BROOKLYN NY SHPITALNIK, VILOR MD 1723 E. 12TH ST.2ND FLR BROOKLYN NY SPITZER, JEFFREY MD (b) (6) BROOKLYN NY TSUI, ELLEN C PHD 837 58th STREET 3rd FL BROOKLYN NY YELENA GLOBINA MD 50 COURT STREET SUITE 508A BROOKLYN NY PATHAK, KAMAL D. MD (b) (6) CORNING NY JOLLY, SHARON 77 QUAKER AVE UNIT 202 CORNWALL NY CORTLAND ENT PC 64 POMEROY STREET CORTLAND NY OSIKA & SCARANO PSYCH SVCS 8 Williams Street Elizabethtown NY CHANG, BENJAMIN MD LIBERTY PHYSICAL MED & REHAB ELMHURST NY DR.MATTHEW D'ORTONA, PSY.D (b) (6) ELMIRA NY KUPERBERG, ABRAHAM PHD (b) (6) FAIR LAWN NJ EYES ON ROCHESTER 1157 FAIRPORT ROAD SUITE 201 FAIRPORT NY SAFO MARGARET MD (b) (6) FAR ROCKAWAY NY BAKST, YAEL CCC/SLP (b) (6) FLUSHING NY BUMATAY,JOSEPH MD (b) (6) FLUSHING NY KIM, DAMIAN MD (b) (6) FLUSHING NY ESHKENAZI, AZARIAH MD (b) (6) FOREST HILLS NY FROMER, MARK D MDPC 109-33 71ST ROAD STE 2C FOREST HILLS NY ZOLTAN, ROBERT MD (b) (6) FOREST HILLS NY GURTOVY, MARK MD 2150 CENTER AVE STE 1-B FORT LEE NJ SUNY/FREDONIA THOMPSON HALL/ROOM W123 FREDONIA NY YU PHD, WEIZHEN (b) (6) FRESH MEADOWS NY KAKANI, RAJESH MD ADVANCED OTOLARYNGOLOGY PC GARDEN CITY NY BONANNO, PHILIP MD 70 GLEN STREET ROOM 380 GLEN COVE NY GLENS FALLS HOSPITAL 102 PARK ST., SUITE B-2 GLENS FALLS NY OSIKA & SCARANO PSYCH SVC PC 5 PINE STREET GLENS FALLS NY BEDARD, JOEL MD (b) (6) HEMPSTEAD NY DEMARCO, LAURA PHD (b) (6) HORNELL NY MILESTONE PSYCHIATRIC SVCS PC 15 PLEASANT STREET HORNELL NY NEERUKONDA, SAMPATH MD (b) (6) HORNELL NY

CAYUGA COMP PSYCH SERVICES, PC TIOGA PLACE ON ITHACA COMMONS ITHACA NY LEXINGTON HEARING & SPEECH CTR 25-26 75TH STREET JACKSON HEIGHTS NY TITONE, FRANK R. MD (b) (6) JACKSON HEIGHTS NY JAMESTOWN OPTOMETRIC GROUP DBA/SPECTRUM EYE CARE JAMESTOWN NY RUBIN, CHARLES MD (b) (6) JOHNSON CITY NY SCHLEUDERER, CLAUDE PHD (b) (6) KINGSTON NY ALBANY EYE PHYSICIAN & SURGEON 930 ALBANY SHAKER ROAD LATHAM NY PHELPS, STEPHEN W. PHD (b) (6) LAURENS NY FEINER, LEONARD MD (b) (6) LAWRENCE NY LONG ISLAND E.N.T.ASSOCS PC 100 EAST SUNRISE HWY STE A LINDENHURST NY THOMAS MYERS PHD 25306 WEST END DR 2ND FL LITTLE NECK NY WAKSLAK, HARRY PHD (b) (6) LONG BEACH NY DURANTE, ANTHONY J. MD (b) (6) MINEOLA NY SHARON JOLLY & ASSOCIATES 101 STAGE ROAD MONROE NY

BRONX PSYCHOLOGY SERVICES,PLLC 27 Melrose Ave Mount Vernon NY BENJAMIN, ANAT MD (b) (6) NEW HYDE PARK NY HESS, DAVID MD CARDIO CONSULT OF LONG ISLAND NEW HYDE PARK NY

HIGHLAND OPHTHALMOLOGY ASSOC 140 EXECUTIVE DR NEW WINDSOR NY BERNARD, PETER J. MD (b) (6) NEW YORK NY CHENG, ANDREW MD (b) (6) NEW YORK NY ENG NANCY PHD. SP/L 9 MOTT STREET SUITE 200 NEW YORK NY FROMER, MARK D MDPC (b) (6) NEW YORK NY NEYSTAT, MARINA MD WEILL CORNELL MED COLL ALUMNI NEW YORK NY KATZ, SUSAN 240 EAST 82nd ST APT 4E NEW YORK CITY NY RUBIN PSYCHOLOGICAL SVCS PC 320 ROBINSON AVE STE 201A NEWBURGH NY BUFFALO HEARING & SPEECH CTR 6941 ELAINE DRIVE SUITE 4 NIAGARA FALLS NY BERTI, MARTHA SLP PC (b) (6) NORTHPORT NY REHABILITATION TODAY SERVICES 784 MAIN STREET OLEAN NY SHAPIRO, ARNOLD L. MD (b) (6) PENN YAN NY WEINBERG, JERRY C MD PENNSPORT MALL PHILADELPHIA PA LONG ISLAND E.N.T. ASSOC. PC 875 OLD COUNTRY ROAD SUITE 200 PLAINVIEW NY MYERS, BONNIE CCC/SLP (b) (6) Plattsburgh NY NORTH COUNTRY KIDS 22 New York Road PLATTSBURGH NY PICHE JACQUES MD PO BOX 1732 PLATTSBURGH NY MORGAN,RITA M.S. (b) (6) POMONA NY EAST END EYE ASSOCIATES 251 EAST OAKLAND AVENUE PORT JEFFERSON NY LAGO, JESUS A. MD (b) (6) PURCHASE NY GLENS FALLS HOSPITAL QUEENSBURY NY LIOTTA RICHARD PHD PO BOX 229 RAINBOW LAKE NY SMUGLIN, CLAUDIA MD (b) (6) REGO PARK NY ACM MEDICAL LABORATORIES INC 160 ELM GROVE PARK ROCHESTER NY ADIRONDACK MEDICAL CENTER LAKE COLBY DRIVE SARANAC LAKE NY NO COUNTRY FAM PHYSICIANS PC 309 COUNTY RTE 47-STE 1 SARANAC LAKE NY BRENNAN, HOPE SLP (b) (6) SAUGERTIES NY GALETTE, FRITZ PHD (b) (6) STATEN ISLAND NY HAHN, JUNG LEE MD (b) (6) STATEN ISLAND NY STATEN ISLAND UNIVERSITY HOSP 475 SEAVIEW AVENUE STATEN ISLAND NY EYECARE OF CNY 2901 COURT STREET SYRACUSE NY ENT & ALLERGY ASSOCIATES 75 SOUTH BROADWAY, 3RD FLOOR WHITE PLAINS NY STURM, JOSEPH MD (b) (6) Woodmere NY RATHI, SEEMA MD (b) (6) YONKERS NY ST JOHNS RIVERSIDE HOSPITAL 967 NORTH BROADWAY YONKERS NY YORKTOWN BERNSTEIN, MARTIN MD (b) (6) HEIGHTS NY Zip 12205 12203 11510 11364 10457 10462 10465 10461 10465 10463 11224 11224 11233 11210 11208 11209 11215 11238 11205 11235 11229 11215 11220 11201 14830 12518 13045 12932 11373 14901 7410 14450 11691 11367 11366 11354 11375 11375 11375 7024 14063 11366 11530 11542 12801 12801 11550 14843 14843 14843

14850 11370 11372 14701 13790 12401 12110 13796 11559 11757 11362 11561 11501 10950

10552 11040 11040

12553 10128 10013 10013 10021 10065 10028 12550 14304 11768 14760 14527 19148 11803 12901 12903 12901 10970 11777 10577 12804 12976 11374 14624 12983 12983 12477 10305 10305 10305 13208 10601 11598 10701 10701

10598 Alphabetical Vendor List Ohio FY 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

ACCESS 2 492 S High St Ste 200 (614) 899-6666 L-Interp INTERPRETERS (b) (6) Columbus f:(614) 464-3004 (b) (6) OH 43215

ADAMS COUNTY (937) 386-3441 ANC REGIONAL 230 MEDICAL CENTER DR MEDICAL CENTER (b) (6) f:(937) 386-3459 SEAMAN OH 45679

ADAMS COUNTY 230 MEDICAL CENTER DR (937) 386-3441 FAC REGIONAL MEDICAL CENTER (b) (6) SEAMAN f:(937) 386-3459 OH 45679

Page 1 of 94 Thursday, October 26, 2017 ADVANTAGE 6900 Ridge Rd (440) 843-9900 ANC (b) (6) IMAGING Scheduler (b) (6) Parma f:(440) 843-9901 OH 44129 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

ADVANTAGE 3733 PARK EAST DRIVE (216) 292-9998 ANC (b) (6) IMAGING (b) (6) BEACHWOOD f:(216) 292-9799 OH 44122

AFFINITY MEDICAL 845 EIGHTH ST NE SUITE #3 330-832-8761 ANC CENTER (b) (6) MASSILLON f: OH 44646

AINA, OLAYINKA, (b) (6) (b) (6) FAC M.D. (b) (6) PEEBLES OH 45660

Page 2 of 94 Thursday, October 26, 2017

AINA, OLAYINKA, (b) (6) (b) (6) IM, CD, ANC (b) (6) M.D. Scheduler (b) (6) PEEBLES OH 45660 (b) (6)

Alice Wang PSY D (b) (6) (b) (6) Psych (b) (6)

(b) (6) Jackson OH 45640

Address Phone Speciality Email Vendor Name Vendor Number

AMANAMBU, APEX MEDICAL EVALUATION 330-375-0000 IM [email protected] CHIMEZIE, M.D. SERVICES 1655 W. MARKET ST. STE L (b) (6) AKRON f:(330) 375-0002 OH 44313

AMCE Physicians 1 COURTHOUSE LANE SUITE 2 (800) 440-3305 IM (b) (6) Group (b) (6) MARIETTA f:(877) 468-4543 OH 45750

Page 3 of 94 Thursday, October 26, 2017

AMCE Physicians 1799 Akron-Peninsula Rd. Suite 305 (800) 440-3305 Psych (b) (6) Group Akron f:(866) 369-4424 (b) (6) (b) (6) OH 44313

AMERIRAD 364 PATTERSOON DR PO 304-598-2291 ANC-INTERP BOX 297 (b) (6) MORGANTOWN f: W 26507 V

ANA MARIA THE DARWOOD BUILDING (b) (6) PSYCH CARRILLO, PHD 23360 CHAGRIN BLVD SUITE 205 (b) (6) BEACHWOOD OH 44122

Address Phone Speciality Email Vendor Name Vendor Number

ANAT NURKO, SLP 12429 Cedar Rd Suite 18 2nd (b) (6) SLP (b) (6) Floor (b) (6) Cleveland Hgts OH 44106

Page 4 of 94 Thursday, October 26, 2017

ASIST MEDICAL 4891 SAWMILL RD STE 210 (614) 451-2027 L/SL-INTERP INTERPRETING AND (b) (6) TRANSLATION INC (b) (6) COLUMBUS f:(614) 451-0442 OH 43235

AYESU-OFFEI, YAW, (b) (6) (b) (6) IM, ANC (b) (6) M.D. (b) (6) COLUMBUS OH 43211

BAILEY 3300 BAILEY ST NW SUITE 330-837-3823 PM, ANC [email protected] REHABILITATION #104 SERVICES (b) (6) MASSILLON f:330-837-8313 OH 44646

BARD, E.M., PHD Cook Prof Bldg 1826 S Main (b) (6) PSYCH (b) (6) Street (b) (6) AKRON OH 44301

Address Phone Speciality Email Vendor Name Vendor Number

Page 5 of 94 Thursday, October 26, 2017

BARTOW, (b) (6) (b) (6) SLP (b) (6) KATHRYN, SLP (b) (6) CLEVELAND (b) (6) OH 44131

BARTOW, 2221 9TH ST SW (TOTAL (b) (6) SLP (b) (6) KATHRYN, SLP LIVING CENTER) (b) (6) CANTON f: OH 44706

BASHIR, SHAHID, (b) (6) (b) (6) ANC-INTERP M.D. (b) (6) CUYAHOGA FALLS f: OH 44223

BERG, NORMAN, Adams County Regional Med 513-745-1040 PSYCH (b) (6) PHD Center 230 Medical Center Drive (b) (6) Seaman f:513-745-4380 OH 45679

BERG, NORMAN, XAVIER HOUSE - SYCAMORE (b) (6) PSYCH (b) (6) PHD HOUSE 3818 WINDING WAY (b) (6) CINCINNATI OH 45207

Page 6 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

BILLMANN, 8150 Corporate Park Dr, Suite 170 (b) (6) Psych (b) (6) STEPHEN PSY D Cincinnati (b) (6) OH 45242 (b) (6)

BILLMANN, 8150 Corporate Park Dr, Suite 170 (b) (6) Psych (b) (6) STEPHEN PSY D Cincinnati

(b) (6) OH 45242

Black, Princess, PSY D 6100 Channingway Blvd. Suite 404 (b) (6) Psych (b) (6) Columbus (b) (6) OH 43232

BOERGER, ALAN, (b) (6) (b) (6) PSYCH (b) (6) PHD (b) (6) TIPP CITY OH 45371

Page 7 of 94 Thursday, October 26, 2017

BONDS, GIOVANNI, (b) (6) (b) (6) PSYCH (b) (6) PHD Scheduler (b) (6) DAYTON OH 45405 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

BOUSQUET, DAVID, THE TOWERS BLDG 5TH (b) (6) PSYCH (b) (6) MED FLOOR 500 MARKET ST STE 518 & 520 (b) (6) STEUBENVILLE OH 43952

BOUSQUET, DAVID, (b) (6) (b) (6) PSYCH (b) (6) MED (b) (6) CADIZ OH 43907

BOWLING GREEN 200 HEALTH CENTER 419-372-2516 SLP (b) (6) STATE UNIV, BUILDING SPEECH AND HEARING CLINIC (b) (6) BOWLING GREEN f:419-372-8089 OH 43402

Page 8 of 94 Thursday, October 26, 2017

BRADFORD, SEVERANCE MEDICAL (b) (6) IM, ANC (b) (6) DOROTHY, M.D. BUILDING 5 SEVERANCE Scheduler CIRCLE SUITE 815 (b) (6) CLEVELAND HEIGHTS OH 44118 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

BRIGHAM, MARK, 195 WADSWORTH RD SUITE (b) (6) ENT, AUDIO (b) (6) D.O. 401 (b) (6) WADSWORTH OH 44281

Budzenksi, Carol A. (b) (6) (b) (6) Psych (b) (6) PHD (b) (6) Stryker OH 43557

CANNON, CHILD CARE CONSULTANTS 614-878-6415 PED cccimanager@cccipediatrics PATRICIA, M.D. INC. 111 INAH AVE .com (b) (6) COLUMBUS f:(614) 878-7946 OH 43228

Page 9 of 94 Thursday, October 26, 2017

CANTON 2600 W TUSCARAWAS SUITE 330-456-0047 OPTH [email protected] OPTHALMOLOGY 200 Scheduler ASSOCIATES (b) (6) CANTON f:330-456-9308 OH 44708 (b) (6)

CARDIOLOGY GSH PULMONARY SVC 513-862-2412 INTERP (b) (6) ASSOCIATES OF (ATTN: (b) (6) 375 DIXMYTH CINCINNATI RD (b) (6) CINCINNATI f:513-862-2952 OH 45220

Address Phone Speciality Email Vendor Name Vendor Number

CE PROVIDER 5850 Ridge Rd #200 (877) 534-5153 IM, PED, ANC ceproviderservices@yahoo. SERVICES com (b) (6) PARMA f:(877) 258-2461 OH 44129

CE PROVIDER 260 Niles Cortland RD NE (877) 534-5153 IM,Ped ceproviderservices@yahoo. SERVICES com (b) (6) WARREN f:(877) 258-2461 OH 44484

Page 10 of 94 Thursday, October 26, 2017

CE PROVIDER Edgerton Family Chiropractic (877) 534-5153 IM, PED ceproviderservices@yahoo. com SERVICES 113 W Lynn St Scheduler (b) (6) Edgerton f:(877) 258-2461 OH 43517 (b) (6)

CE PROVIDER SIMPSON CHIROPRATIC 981 (877) 534-5153 IM, PED SERVICES ASHLAND RD (b) (6) Mansfield f:(877) 258-2461 OH 44905

CE PROVIDER 4190 HOLIDAY ST NEW, (877) 534-5153 IM, PE, ORTHO CEPROVIDERSERVICES@ SERVICES PRESTON CHIROPRACTIC HOTMAIL.COM (b) (6) CANTON f:(877) 253-1198 OH 44718

Address Phone Speciality Email Vendor Name Vendor Number

CHIARELLA, DAVID, 1950 NILES-COURTLAND RD (b) (6) PSYCH (b) (6) PHD NE ST RT 46 STE 6 (b) (6) WARREN OH 44484

Page 11 of 94 Thursday, October 26, 2017

CHIARELLA, DAVID, LIBERTY PLACE 3200 Belmont (2nd (b) (6) PSYCH (b) (6) PHD Floor) Scheduler (b) (6) YOUNGSTOWN OH 44505 (b) (6)

CHILD & FAMILY 822 PORTAGE TRAIL 330-923-9344 PSYCH (b) (6) PSYCH ASSOCIATES (b) (6) CUYAHOGA FALLS f:(866) 248-1103 OH 44221

CHILD & FAMILY 822 PORTAGE TRAIL (330) 923-9344 PSYCH (b) (6) PSYCHOLOGICAL ASSOCIATES (b) (6) CUYAHOGA FALLS f: OH 44221

CHUCK, JORETHIA (b) (6) (b) (6) Psych (b) (6) PHD (b) (6) Cleveland OH 44103

Address Phone Speciality Email Vendor Name Vendor Number

Page 12 of 94 Thursday, October 26, 2017

CIARRONE, JOHN, Wakeman Community Library 33 (b) (6) SLP (b) (6) SLP Pleasant Street Scheduler (b) (6) Wakeman OH 44889 (b) (6)

CIESLAK, HAMILTON LANE LIBRARY - (b) (6) SLP (b) (6) BERNADETTE SLP 300 N. THIRD STREET (b) (6) HAMILTON OH 45011

CLEVELAND CLINIC WESTLAKE MEDICAL (440) 250-5744 ENT, AUDIO (b) (6) FOUNDATION CAMPUS, 850 COLUMBIA RD., SUITE 100 (b) (6) WESTLAKE f:(440) 250-5755 OH 44145

CLINIC MEDICAL PO BOX 92237 ANC-INTERP SERVICES CO (b) (6) CLEVELAND f: OH 44193

Page 13 of 94 Thursday, October 26, 2017

COLUMBUS P O BOX 714150 ANC-INTERP RADIOLGY Scheduler (b) (6) CINCINNATI f: OH 45271-4150 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

COMMUNITY CLEVELAND HEARING & (216) 231-8787 SL-INTERP SERVICES FOR THE SPEECH CTR 11635 EUCLID AVE DEAF CLEVELAND (b) (6) OH 44106 f:(216) 795-2135

COMMUNITY 212 E EXCHANGE ST (330) 376-9494 SL-INTERP SERVICES FOR THE DEAF (b) (6) AKRON f: OH 44304

COMMUNITY 4700 MASSILLON RD. 330-896-9119 SLP [email protected] SPEECH SERVICES (b) (6) GREEN f:330-896-1185 OH 44232

Page 14 of 94 Thursday, October 26, 2017

CONSULTING 3250 W MARKET ST STE 106 330-873-9516 PSYCH [email protected] PSYCHOLOGY INC Scheduler (b) (6) FAIRLAWN f:(330) 864-8678 OH 44333 (b) (6)

Cooper, Marsha D. (b) (6) (b) (6) IM, CD (b) (6) MD (b) (6) Sandusky OH 44870

Address Phone Speciality Email Vendor Name Vendor Number

COOPERRIDER, JON (b) (6) (b) (6) OPTH (b) (6)

(b) (6) Mansfield OH 44906

CORBUS JOHNSON 580 S HIGH ST STE 250 (614) 349-8014 PSYCH (b) (6) CONSULTING LLC (b) (6) COLUMBUS f:(614) 221-8912 OH 43215

Page 15 of 94 Thursday, October 26, 2017

DALLARA, ROBERT, 550 E ROBINSON AVE SUITE (b) (6) PSYCH (b) (6) PHD #8 Scheduler (b) (6) BARBERTON OH 44203 (b) (6)

DAVIS, RICHARD, 14805 DETROIT RD STE #450 (b) (6) PSYCH (b) (6) M.A. (b) (6) LAKEWOOD OH 44107

DEAF SERVICES 5830 NORTH HIGH STREET (614) 841-1991 SL-INTERP CENTER INC (b) (6) WORTHINGTON f:(614) 841-4909 OH 43085

Address Phone Speciality Email Vendor Name Vendor Number

Deaf Services 1835 OAKLAND AVE (PIXLEY (740) 356-7200 SL-INTERP CenterPortsmouth BLDG) (b) (6) PORTSMOUTH f:(740) 356-6110

OH 45662

Page 16 of 94 Thursday, October 26, 2017

DEARDORFF, PAUL (b) (6) (800) 239-8886 PSYCH [email protected] PHD (FORPSYCH) Scheduler (b) (6) FINDLAY f:(513) 569-5933 OH 45840 (b) (6)

DEARDORFF, PAUL (b) (6) (800) 239-8886 Psych [email protected] PHD (FORPSYCH) (b) (6) GALLIPOLIS f:(513) 871-7281 OH 45631

DEARDORFF, PAUL (b) (6) (800) 239-8886 Psych [email protected] PHD (FORPSYCH) (b) (6) Peebles f:(513) 871-7281 OH 45660

DEARDORFF, PAUL (b) (6) (800) 239-8886 PSYCH [email protected] PHD (FORPSYCH) (b) (6) NEW PHILADELPHIA f:(513) 871-7281 OH 44633

Address Phone Speciality Email Vendor Name Vendor Number

Page 17 of 94 Thursday, October 26, 2017

DEARDORFF, PAUL, (b) (6) (800) 239-8886 PSYCH PHD (FORPSYCH) (b) (6) SIDNEY f:(513) 871-7281 Scheduler OH 45365 (b) (6)

DEARDORFF, PAUL, 15711 MADISON AVE STE 102 PSYCH PHD (FORPSYCH) (b) (6) LAKEWOOD f:(513) 871-7281 OH 44107

DEARDORFF, PAUL, 200 PUTNAM ST STE 522 800-239-8886 PSYCH PHD (FORPSYCH) (b) (6) MARIETTA f:(513) 871-7281 OH 45750

DEARDORFF, PAUL, (b) (6) (800) 239-8886 PSYCH (b) (6) PHD (FORPSYCH) (b) (6) PORTSMOUTH f:(513) 871-7281 OH 45662

Page 18 of 94 Thursday, October 26, 2017

DEARDORFF, PAUL, (b) (6) (b) (6) PSYCH [email protected] PHD (FORPSYCH) Scheduler (b) (6) VANDALIA f:(513) 871-7281 OH 45377 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

DEARDORFF, PAUL, (b) (6) (800) 239-8886 PSYCH PHD (FORPSYCH) (b) (6) LIMA f:(513) 871-7281 OH 45805

DEARDORFF, PAUL, 731 E MAIN ST UNIT 16 (800) 239-8886 PSYCH [email protected] PHD (FORPSYCH) (b) (6) JACKSON f:(513) 871-7281 OH 45640

DEARDORFF, PAUL, COSHOCTON COUNTY JOB (800) 239-8886 PSYCH PHD (FORPSYCH) AND FAMILY SERVICES (b) (6) COSCHOCTON f:(513) 871-7285 OH 43812

Page 19 of 94 Thursday, October 26, 2017

DEARDORFF, PAUL, THE WESTGATE BUILDING, (800) 239-8886 Psych PHD (FORPSYCH) 3450 W. CENTRAL AVE., STE Scheduler 334 (b) (6) TOLEDO f:(513) 871-7281 OH 43606 (b) (6)

DEARDORFF, PAUL, (b) (6) (b) (6) PSYCH PHD (FORPSYCH) (b) (6) MILFORD

OH 45150

Address Phone Speciality Email Vendor Name Vendor Number

DEARDORFF, PAUL, (b) (6) (b) (6) PSYCH (b) (6) PHD (FORPSYCH) (b) (6) CINCINNATI f:513-871-7281 OH 45208

DEARDORFF, PAUL, (b) (6) (800) 239-8886 PSYCH (b) (6) PHD, (FORPSYCH) (b) (6) PAULDING f:513-871-7281 OH 45879

Page 20 of 94 Thursday, October 26, 2017

DEARDORFF, PAUL, 1159 LYONS RD BLG E (b) (6) PSYCH (b) (6) PSYD (FORPSYCH) Scheduler (b) (6) CENTERVILLE f: OH 45459 (b) (6)

DeCola, Louis PHD 355 West Prospect Rd. Suite (b) (6) Psych (b) (6) 116C (b) (6) Ashtabula OH 44004

Doyle, Andria PH.D. (b) (6) (b) (6) Psych (b) (6)

(b) (6) Findlay OH 45840

Address Phone Speciality Email Vendor Name Vendor Number

DR PEDERZOLLI & (b) (6) . 330-332-9991 OPTH (b) (6) BRINE MDS (b) (6) SALEM f:330-332-2188 OH 44460

Page 21 of 94 Thursday, October 26, 2017

DRANKWALTER, (b) (6) (b) (6) ENT, ANC (b) (6) TIMOTHY, D.O. (b) (6) GAHANNA (b) (6) OH 43230

DUBEY, SUDHIR, (b) (6) (b) (6) PSYCH (b) (6) PSYD (b) (6) COLUMBUS f: OH 43220

DUBEY, SUDHIR, (b) (6) (b) (6) PSYCH (b) (6) PSYD (b) (6) MARION OH 43302

DUNN, RYAN, PHD (b) (6) (b) (6) PSYCH newlifecounseling@roadrun ner.com (b) (6) DOVER OH 44622

Address Phone Speciality Email Vendor Name Vendor Number

Page 22 of 94 Thursday, October 26, 2017

EAST OHIO 90 N FOURTH ST (740) 633-4444 ANC REGIONAL Scheduler HOSPITAL (b) (6) MARTINS FERRY f:(740) 633-4124 OH 43935 (b) (6)

EAST OHIO VASCULAR LAB 90 N 740-633-4444 ANC REGIONAL FOURTH ST HOSPITAL (b) (6) MARTINS FERRY f: OH 43935

EAST OHIO RADIOLOGY DEPT 90 N 740-633-4444 ANC, FAC REGIONAL FOURTH ST HOSPITAL (b) (6) MARTINS FERRY f: OH 43935

EASTER SEALS 3930 FULTON DR NW SUITE 330-494-3642 SLP 107 (b) (6) CANTON f:330-494-4538 OH 44718

Page 23 of 94 Thursday, October 26, 2017

EASTER SEALS OF 3085 W MARKET ST SUITE 124 330-836-9741 SLP NORTHEAST OHIO Scheduler (b) (6) AKRON f:(330) 836-4967 OH 44333 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

EASTER SEALS OF 1929 A EAST ROYALTON RD 440-838-0990 SLP NORTHEAST OHIO (b) (6) BROADVIEW HGTS f:440-838-8440 OH 44147

EASTER SEALS OF 14701 DETROIT AVE SUITE 216-228-5170 SLP NORTHEAST OHIO #470 (b) (6) LAKEWOOD f:216-228-1018 OH 44107

EASTER SEALS OF 4841 Monroe St Ste 201 (419) 535-5750 SLP NORTHERN OHIO (b) (6) TOLEDO f:(419) 535-5780 OH 43623

Page 24 of 94 Thursday, October 26, 2017

EASTER SEALS OF 101 S STONE ST 419-332-3016 SLP NORTHERN OHIO Scheduler (b) (6) FREMONT f:419-332-3048 OH 43420 (b) (6)

EASTER SEALS OF 2173 N. RIDGE RD SUITE G 440-324-6600 SLP NORTHERN OHIO (b) (6) LORAIN f:440-324-6602 OH 44055

Address Phone Speciality Email Vendor Name Vendor Number

EDWARDS, KEVIN, (b) (6) (b) (6) psych (b) (6) PHD (b) (6) Thornville f: OH 43076

ELTINA DAVIS SLP 2000 AUBURN DR ONE (b) (6) SLP (b) (6) CHAGRIN HIGHLANDS SUITE 200 (b) (6) BEACHWOOD f: OH 44122

Page 25 of 94 Thursday, October 26, 2017

ELTINA DAVIS SLP (b) (6) (b) (6) SLP (b) (6) f: (b) (6) ST. CLAIRSVILLE OH 43950 (b) (6)

ELTINA DAVIS SLP (b) (6) (b) (6) SLP f: (b) (6) ATHENS

OH 45701

ENT PHYSICIANS, 3829 WOODLEY RD BLDG B 419-474-9324 ENT, ANC INC (b) (6) TOLEDO f:419-474-9345 OH 43606

Address Phone Speciality Email Vendor Name Vendor Number

EVANS, MICHELE, 4937 WEST BROAD STREET STE (b) (6) PSYCH (b) (6) PHD 205 (b) (6) COLUMBUS f: OH 43228

Page 26 of 94 Thursday, October 26, 2017

EVANS, THOMAS, (b) (6) (b) (6) PSYCH (b) (6) PHD Scheduler (b) (6) MILAN OH 44846 (b) (6)

EYE CARE 1075 WEST WESTERN 330-746-7691 OPTH (b) (6) ASSOCIATES RESERVE RD (b) (6) POLAND f:330-743-8322 OH 44514

EYE SITE OF LIMA 1034 W MARKET ST (419) 228-8116 OPTH (b) (6) f:(419) 228-1160 (b) (6) LIMA OH 45805

FAMILY SERVICES 2211 Arbor Blvd (937) 640-8032 SL-INTERP ASSOCIATION (b) (6) DAYTON f:(937) 640-8036 OH 45439

Address Phone Speciality Email Vendor Name Vendor Number

Page 27 of 94 Thursday, October 26, 2017

FARRELL, MICHAEL, 375 GLENSPRINGS DR SUITE (b) (6) PSYCH (b) (6) PHD #300 Scheduler (b) (6) CINCINNATI OH 45246 (b) (6)

FAUST MICHAEL FAUST, PHD 216-363-2386 PSYCH (b) (6) PSYCHOLOGICAL LUTHERAN HOSPITAL 1730 SERVICES W. 25TH ST (b) (6) CLEVELAND f:(216) 696-7488 OH 44113

FILE, MARY, M.D. ST THOMAS PROF CTR 444 N (b) (6) OPTH MAIN ST STE 423 (b) (6) AKRON OH 44310

FIRELANDS 1111 HAYES AVE 800-342-1177 ANC (b) (6) REGIONAL MEDICAL CENTER (b) (6) SANDUSKY f:419-557-7039 OH 44870

Page 28 of 94 Thursday, October 26, 2017

Flexman-Myers Clinic WEST PAVILLION 1ST FLOOR 937-256-5300 PSYCH [email protected] m SUITE C 1 ELIZABETH PLACE Scheduler (b) (6) DAYTON f:937-258-4162 OH 45301 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

FORENSIC PSYCH 70 W ERIE ST (440) 721-4994 PSYCH (b) (6) CENTER (b) (6) PAINESVILLE f:(888) 752-8808 OH 44077

FORENSIC PSYCH 4822 MARKET STREET (330) 259-8822 PSYCH (b) (6) CENTER (b) (6) BOARDMAN f:(888) 752-8808 OH 44512

FORPSYCH 953 S SOUTH STREET 800-239-8886 f:513- PSYCH 871-7281 (b) (6) WILMINGTON OH 45177

Page 29 of 94 Thursday, October 26, 2017

Forpsych 30 Custer Rd (800) 239-8886 Psych [email protected] f:(513) 871-7281 (b) (6) Heath (b) (6) OH 43056

FORPSYCH 2882 WHIPPLE AVE NW (800) 239-8886 PSYCH [email protected] f:(513) 871-7281 (b) (6) CANTON OH 44708

Address Phone Speciality Email Vendor Name Vendor Number

FORT HAMILTON 630 EATON AVE (513) 867-2263 ANC HOSPITAL (b) (6) HAMILTON f: OH 45013

FORT HAMILTON X-RAY DEPT 630 EATON AVE (513) 867-2263 ANC HOSPITAL (b) (6) HAMILTON f:(513) 867-2414 OH 45013

Page 30 of 94 Thursday, October 26, 2017

GENESIS GOVT BILLER PATIENT 740-454-4301 ANC HEALTHCARE ACCTS. RADIOLOGY 2951 N Scheduler MAPLE AVE (b) (6) ZANESVILLE f:(740) 454-4326 OH 43701 (b) (6)

GENESIS PHYSICIANS PAVILION 945 (740) 454-4242 ANC HEALTHCARE, BETHESDA DR (BETHESDA) (b) (6) ZANESVILLE f:(740) 454-4326 OH 43701

GENESIS PHYSICIANS PAVILION 740-454-4242 ANC HEALTHCARE, RESPIRATORY DEPT. 945 (BETHESDA) BETHESEDA DRIVE (b) (6) ZANESVILLE f:(740) 454-4326 OH 43701

Address Phone Speciality Email Vendor Name Vendor Number

Page 31 of 94 Thursday, October 26, 2017

GERMAINE 4300 OLD SALEM RD (937) 836-8451 L-INTERP (b) (6) LANGUAGE Scheduler CENTER INC (b) (6) ENGLEWOOD f:(937) 832-4567 OH 45322 (b) (6)

GLENWAY TRIHEALTH TRI HEALTH MEDICAL 513-862-2412 ANC (b) (6) / GOOD CENTER 6350 GLENWAY AVE SAMARITAN STE #101 HOSPITAL (b) (6) CINCINNATI f:513-862-2952 OH 45211

GOOD SAMARITAN 375 DIXMYTH RD 513-862-2412 IM, CD, ANC (b) (6) HOSPITAL (b) (6) CINCINNATI f:513-862-2952 OH 45220

GOOD-SISSON, (b) (6) (b) (6) SLP (b) (6) TRACI, SLP (b) (6) CHILLICOTHE OH 45601

Page 32 of 94 Thursday, October 26, 2017

GRODNER, (b) (6) (b) (6) IM, CD, ANC HERBERT M.D. (b) (6) Scheduler (b) (6) WESTERVILLE OH 43081 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

GRODNER, (b) (6) (b) (6) ANC (b) (6) HERBERT M.D. (b) (6) WESTERVILLE OH 43081

GRONECK, (b) (6) (b) (6) PSYCH (b) (6) TAYLOR, PSYD (b) (6) WILIMINGTON OH 45177

GRUENFELD, 5500 MARKET STREET STE #90 (b) (6) PSYCH (b) (6) KENNETH, PSYD (b) (6) YOUNGSTOWN OH 44512

Page 33 of 94 Thursday, October 26, 2017

HAAGA, JENNIFER, 106 E MARKET STREET SUITE (b) (6) Psych (b) (6) PSYD 605 Scheduler (b) (6) WARREN OH 44481 (b) (6)

Halmi, Stephen, PSY D 1303 Lyons Rd. Building H (b) (6) Psych (b) (6)

(b) (6) Dayton OH 45458

Address Phone Speciality Email Vendor Name Vendor Number

HARRIS, GORDON, (b) (6) (b) (6) PSYCH (b) (6) PHD (b) (6) DAYTON OH 45415

HEALTHLINK 710 CLEVELAND AVE (419) 333-6411 IM/PM/ORTHO (b) (6) OCCUPATIONAL HLTH SVCS (b) (6) Fremont f:(419) 333-6438 OH 43420

Page 34 of 94 Thursday, October 26, 2017

HEARING / SPEECH 2825 BURNET AVE Suite 304 (513) 221-1703 SL-Interp & DEAF CENTER OF Scheduler CINCINNATI (b) (6) CINCINNATI f:513-221-5505 OH 45219 (b) (6)

HESS, ROBERT, M.D. (b) (6) (b) (6) -0566 f:614- NE, ORTHO (b) (6) 895-7123 (b) (6) WESTERVILLE OH 43081

HOLZER MEDICAL TRACI GOOD, SLP 100 740-446-5121 SLP (b) (6) CENTER JACKSON PIKE (b) (6) GALLIPOLIS f:(740) 441-3335 OH 45631

Address Phone Speciality Email Vendor Name Vendor Number

HUNT, AILEEN, SLP The Westgate Bldg 3450 W (b) (6) SLP (b) (6) Central Ave Ste 334 (b) (6) TOLEDO OH 43606

Page 35 of 94 Thursday, October 26, 2017

ICKES, CURTIS, PHD 1060 CLAREMONT AVE #6 (b) (6) PSYCH (b) (6) f: (b) (6) ASHLAND (b) (6) OH 44805

IEMMA, JOSEPH, M.D. ATTN: DR. DUNCAN 96 (b) (6) IM, CD, ANC (b) (6) GRAHAM RD SUITE B (b) (6) CUYAHOGA FALLS OH 44223

IMA, PC DEACONESS PROFESSIONAL (216) 661-1687 IM, PED, PM, (b) (6) BUILDING 4269 PEARL RD. ANC SUITE 102 (b) (6) CLEVELAND f: OH 44109

IMA, PC 26 Nesbitt Rd. Suite 154 (724) 698-7310 PSYCH (b) (6) f: (b) (6) New Castle PA 16105

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 36 of 94 Thursday, October 26, 2017

IMA, PC 4269 Pearl Rd. Ste 102 f: PSYCH (b) (6) (b) (6) Cleveland OH 44109 (b) (6)

INTERNATIONAL 207 E TALLMADGE AVE 330-376-5106 L-INTERP INSTITUTE (b) (6) AKRON f: OH 44310

INTERNATIONAL PO BOX 19323 440-599-9999 L-INTERP LANGUAGE BANK (b) (6) CONNEAUT f:440-599-9777 OH 44030

IOMI PATTEN SLP (b) (6) (b) (6) SLP (b) (6)

(b) (6) MARYSVILLE f: OH 43040

Page 37 of 94 Thursday, October 26, 2017

IRONTON M & G TRIPLETT LLC 401 (513) 404-7202 FAC PSYCHOLOGICAL CENTER ST STE B SERVICES Scheduler (b) (6) IRONTON f: OH 45638 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

JAMES, LARRY PHD 70 BIRCH ALLEY SUITE 240 (b) (6) PSYCH (b) (6)

(b) (6) BEAVERCREEK OH 45440

Janco-Gidley, PhD 1701 Mentor Ave., Ste. 10 (b) (6) Psych (b) (6) f: (b) (6) Painesville OH 44077

Jennifer Ujcich SLP Columbus Metropolitan Library (b) (6) SLP (b) (6) Shepard Branch 850 N. Nelson Rd. (b) (6) Columbus OH 43219

Page 38 of 94 Thursday, October 26, 2017

JOHNSON CORBUS 580 S HIGH ST STE 250 (614) 349-8014 PSYCH (b) (6)

CONSULTING LLC Scheduler (b) (6) COLUMBUS f:(614) 221-8912 OH 43215 (b) (6)

JONES, MARY, PHD 4134 LINDEN AVE. STE. 200 (b) (6) PSYCH (b) (6)

(b) (6) DAYTON OH 45432

Address Phone Speciality Email Vendor Name Vendor Number

JOSELL, PAUL, PSYD 5564 WILSON MILLS RD (b) (6) PSYCH (b) (6) SUITE #201 (b) (6) HIGHLAND HGTS OH 44143

KELLY, JAMES 134 WEST SOUTH (b) (6) PSYCH (b) (6) BRUCE, M.ED BOUNDARY STE R (b) (6) PERRYSBURG OH 43551

Page 39 of 94 Thursday, October 26, 2017

KENFORD, SUSAN, XAVIER UNIV. SYCAMORE (b) (6) PSYCH (b) (6) PHD HOUSE 3818 WINDING WAY Scheduler (b) (6) CINCINNATI OH 45207 (b) (6)

KENNINGTON, 2100 EMMANUEL WAY SUITE A (b) (6) IM, OR, PM, (b) (6) ROHN TYSEN, M.D. NEURO (b) (6) SPRINGFIELD OH 45502

KESSLER, WILLIAM, 2600 FAR HILLS AVE SUITE #15 (b) (6) OPTH (b) (6) M.D. (b) (6) DAYTON OH 45419

Address Phone Speciality Email Vendor Name Vendor Number

KETTERING 7901 SCHATZ (937) 439-0390 ANC-INTERP NETWORK RADIOLOGISTS (b) (6) DAYTON f:(937) 439-4082 OH 45459

Page 40 of 94 Thursday, October 26, 2017

KIRSTEIN & ASSOC, Grande Central Station, 4600 (513) 631-8889 Opth (b) (6) INC Smith Rd C-10 Scheduler (b) (6) Norwood f:(513) 631-8891 OH 45212 (b) (6)

KONIECZNY, J. 8166 MARKET STREET SUITE M (b) (6) PSYCH (b) (6) JOSEPH, PHD (b) (6) BOARDMAN f: OH 44512

KONIECZNY, 23811 CHAGRIN BLVD (b) (6) PSYCH (b) (6) JOESPH, PHD CHAGRIN PLAZA E STE LL70 (b) (6) BEACHWOOD f: OH 44122

KONIECZNY, 605 S TRIMBLE RD STE D (b) (6) PSYCH (b) (6) JOESPH, PHD (b) (6) MANSFIELD f: OH 44906

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 41 of 94 Thursday, October 26, 2017

Kopey, Stephanie A. (b) (6) (b) (6) IM, PM (b) (6) Scheduler (b) (6) Warren OH 44484 (b) (6)

KORICKE, 21403 CHAGRIN BLVD. STE. (b) (6) PSYCH (b) (6) DEBORAH, PHD 104 (b) (6) BEACHWOOD OH 44122

KORICKE, 20800 WESTGATE MALL STE (b) (6) PSYCH (b) (6) DEBORAH, PHD 200 (b) (6) FAIRVIEW PARK OH 44126

KOSE, ROBERT, M.D. (b) (6) (b) (6) ANC-INTERP (b) (6) (b) (6) MAUMEE OH 43537

KRASNYANSKY, 24755 CHAGRIN BLVD SUITE (b) (6) CD, IM, ANC (b) (6) MD, INNA #320 (b) (6) BEACHWOOD OH 44122

Page 42 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

KRUPADEV, H.L. (b) (6) (b) (6) IM, CD, ANC (b) (6) M.D. MARIETTA (b) (6) (b) (6) OH 45750

KRUSZEWSKI, 3450 W Central Ave. Ste 334 (b) (6) SLP (b) (6) LYNN, SLP (b) (6) TOLEDO OH 43606

KURZHALS, 23986 STATE LINE RD SUITE (b) (6) PSYCH (b) (6) ROBERT PHD 102 (b) (6) BRIGHT IN 47025

LAKHANI, 1255 BOARDMAN-CANFIELD (b) (6) IM, ANC (b) (6) PRABHUDAS, M.D. RD SUITE 100 (b) (6) YOUNGSTOWN OH 44512

Page 43 of 94 Thursday, October 26, 2017

LANGUAGE BANK 3740 Glenway Ave. 513-354-5702 L-INTERP (b) (6) f:513-345-8559 Scheduler (b) (6) CINCINNATI OH 45205 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

LE, CHUC P., M.D. BETHESDA CARE 513-731-3399 ORTHO, PM, (b) (6) NORWOOD 4592 ANC MONTGOMERY RD (b) (6) NORWOOD f:(513) 852-3116 OH 45212

LEE HOWARD, INC 580 S HIGH ST STE 100 (614) 444-0961 PSYCH f:(614) 444-0962 (b) (6) COLUMBUS OH 43215

Page 44 of 94 Thursday, October 26, 2017

LEE HOWARD, INC 601 UNDERWOOD STREET (614) 444-0961 PSYCH f:(614) 444-0962 (b) (6) ZANESVILLE OH 43701 (b) (6)

LEE HOWARD, INC 580 S HIGH ST STE 100 (614) 444-0961 PSYCH f:(614) 444-0962 (b) (6) COLUMBUS OH 43215

Address Phone Speciality Email Vendor Name Vendor Number

LESTER, GEORGE, 800 COMPTON RD SUITE #1 (b) (6) PSYCH (b) (6) PSYD (b) (6) CINCINNATI OH 45231

LIANG, JAMES, M.D. 5500 RIDGE RD SUITE #220 (b) (6) PED, ANC (b) (6)

(b) (6) PARMA OH 44129

Page 45 of 94 Thursday, October 26, 2017

LIBERTY MEDICAL CHIROPRACTIC CONCEPTS (502) 451-6085 IM, PM, ANC (b) (6) ASSESSMENTS 5395 N ABBE RD Scheduler (b) (6) ELYRIA f:(877) 551-4548 OH 44035 (b) (6)

LIBERTY MEDICAL GALLIPOLIS CHIROPRACTIC (502) 451-6085 IM, PM, ANC (b) (6) ASSESSMENTS CENTER 990 SECOND AVE (b) (6) GALLIPOLIS f:(877) 551-4548 OH 45631

LIBERTY MEDICAL 168 WEST MAIN ST (502) 451-6085 IM, PM, ANC (b) (6) ASSOCIATES (LMA) (b) (6) WILMINGTON f:(877) 551-4548 OH 45177

Address Phone Speciality Email Vendor Name Vendor Number

LIMA P O BOX 5128 (866) 876-5561 ANC-INTERP RADIOLOGICAL ASSOCIATES (b) (6) LIMA f: OH 45802

Page 46 of 94 Thursday, October 26, 2017

Malcolm, Bruce E. (b) (6) (b) (6) Psych (b) (6) Psy D Scheduler (b) (6) Dover OH 44622 (b) (6)

MARIETTA 401 MATTHEW ST 740-568-5397 ANC MEMORIAL HOSPITAL (b) (6) MARIETTA f: OH 45750

MARIETTA 401 MATTHEW ST 740-374-1434 ANC MEMORIAL HOSPITAL (b) (6) MARIETTA f:(740) 374-1480 OH 45750

Address Phone Speciality Email Vendor Name Vendor Number

MARION LLC 1040 DELAWARE AVE PO ANC ANCILLARY BOX 1827 SERVICES (b) (6) MARION OH 43301

Page 47 of 94 Thursday, October 26, 2017

MARION LLC 1040 DELAWARE AVE (740) 383-7092 ANC ANCILLARY Scheduler SERVICES (b) (6) MARION f:(740) 383-7942 OH 43301 (b) (6)

MCCABE, PAULA, (b) (6) (b) (6) FAC f: (b) (6) HUBBARD OH 44425

MCCABE, PAULA, (b) (6) (b) (6) SLP (b) (6) (b) (6) GIRARD OH 44420

MCINTIRE, 125 EXECUTIVE DR, SUITE 201 (b) (6) PSYCH (b) (6) DONALD, PHD (b) (6) MARION OH 43302

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 48 of 94 Thursday, October 26, 2017

MED & 1010 SUMMIT DRIVE 513-727-0827 IM, CD, ORTHO, (b) (6) OCCUPATIONAL ANC Scheduler HEALTH (b) (6) MIDDLETOWN f:513-621-1060 OH 45042 (b) (6)

MED & 2825 BURNET AVE, SUITE 304 513-621-4202 IM, CD, ANC (b) (6) OCCUPATIONAL HEALTH (b) (6) CINCINNATI f:513-621-1060 OH 45219

MED & FOLKE BLOCK BLDG 4TH 740-774-3640 IM, CD, ORTHO, (b) (6) OCCUPATIONAL FLOOR 14 S PAINT ST ANC HEALTH (b) (6) CHILLICOTHE f:513-621-1060 OH 45601

MED & 806 SIXTH STREET 740-354-6928 IM, CD, ORTHO, (b) (6) OCCUPATIONAL ANC HEALTH (b) (6) PORTSMOUTH f:513-621-1060 OH 45662

Page 49 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

MED & Ackerman Medical Bldg 3080 (513) 405-9180 IM, ORTHO, (b) (6) OCCUPATIONAL Ackerman Blvd Ste 310 CARDIO, Scheduler HEALTH ANCILLARY (b) (6) Kettering f:(513) 621-1060 OH 45429 (b) (6)

MEDICAL 3400 N HIGH STREET, 3RD 614-261-9723 NE (b) (6) EVALUATION FLOOR, SUITE 340 SERVICES (b) (6) COLUMBUS f:614-261-7243 OH 43202

MEDICAL 83 N MILLER RD 330-836-0258 IM, CD, ANC (b) (6) EVALUATION SERVICES (b) (6) AKRON f:330-836-2025 OH 44333

MEDICAL 83 N MILLER RD (330) 836-0258 Ortho, PM, ANC (b) (6) EVALUATION SERVICES (b) (6) AKRON f:(330) 836-2025 OH 44333

Page 50 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

MEDICAL 3400 N. HIGH ST 3RD FLOOR (614) 261-9723 PEDS, ANC (b) (6) EVALUATION Scheduler SERVICES (b) (6) COLUMBUS f:(614) 261-7243 OH 43202 (b) (6)

MEDICAL 3400 N. HIGH STREET 3RD Ortho, ANC (b) (6) EVALUATION FLOOR SERVICES (b) (6) COLUMBUS OH 43202

MEDICAL 3400 N HIGH ST 3RD FLOOR (614) 261-9723 IM, ANC (b) (6) EVALUATION SERVICES (b) (6) COLUMBUS f:(614) 261-7243 OH 43202

MEDICAL X-RAY INC 375 DIXMYTH AVE 513-965-8041 INTERP f: (b) (6) CINCINNATI OH 45220

Page 51 of 94 Thursday, October 26, 2017

MELISSA K LANZA 400 E STATE STREET ST H (b) (6) Psych (b) (6) PHD Scheduler (b) (6) ATHENS OH 45701 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

Mercy Physical 5800 MONROE ST Building A 419-885-8449 PM, ANC (b) (6) Medicine and Rehabilitation (b) (6) SYLVANIA f:419-882-7621 OH 43560

METRO HEALTH 2500 METRO HEALTH DR 2ND (216) 778-4414 PM, ANC (b) (6) MEDICAL CENTER FLOOR REHABILITATION PAVILLION STE 2201 (b) (6) CLEVELAND f:(216) 778-7767 OH 44109

MIDWEST EXAMS 420 CAROLINE RD 440-333-5000 SLP INC (b) (6) YOUNGSTOWN f:440-333-1856 OH 44501

Page 52 of 94 Thursday, October 26, 2017

MIDWEST EXAMS 1932 Niles Courtland Rd NE 440-333-5000 SLP INC Scheduler (b) (6) WARREN f:440-333-1856 OH 44484 (b) (6)

MILLER, MARC, PHD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) NEWARK OH 43055

Address Phone Speciality Email Vendor Name Vendor Number

MILLER, MARC, PHD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) LANCASTER OH 43130

MILLER, NANCY, MONTGOMERY SPEECH 513-469-0971 SLP montgomeryspeechclinic@f PHD, SLP CLINIC, 10768 MONTGOMERY use.net ROAD (b) (6) CINCINNATI f:513-469-1254 OH 45242

Page 53 of 94 Thursday, October 26, 2017

MORELLI-NEDDY, Tri-County Rehabilitation 567 E Main (330) 533-1080 SLP (b) (6) AIMEE, SLP St. Scheduler (b) (6) Canfield f: OH 44406 (b) (6)

MORSE, WAYNE, 1604 E PERKINS AVE. SUITE 201 (b) (6) PSYCH (b) (6) PHD (b) (6) SANDUSKY OH 44870

MYERS, KATHERINE, 1502 UNIVERSITY BLVD, SUITE (b) (6) PSYCH (b) (6) PSYD D (b) (6) HAMILTON OH 45011

Address Phone Speciality Email Vendor Name Vendor Number

MYERS, KATHERINE, 1502 UNIVERSITY BLVD.,SUITE (b) (6) PSYCH (b) (6) PSYD D (b) (6) HAMILTON f: OH 45011

Page 54 of 94 Thursday, October 26, 2017

MYERS, KATHERINE, 1502 UNIVERSITY BLVD., SUITE (b) (6) PSYCH (b) (6) PSYD D Scheduler (b) (6) HAMILTON OH 45011 (b) (6)

MYERS, KATHERINE, 1502 UNIVERSITY BLVD, SUITE (b) (6) PSYCH (b) (6) PSYD D (b) (6) HAMILTON f:

OH 45011

MYERS, KATHERINE, 1502 UNIVERSITY BLVD. SUITE (b) (6) PSYCH (b) (6) PSYD D (b) (6) HAMILTON OH 45011

Nadkarni, Radha B. 2529 Oakstone Dr. Suite B (b) (6) Psych integratedchildcenter@gma PH.D. il.com (b) (6) Columbus OH 43231

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 55 of 94 Thursday, October 26, 2017

NELSON MA, 3450 W CENTRAL AVE THE (b) (6) SLP (b) (6) KATHLEEN WESTGATE BLDG Scheduler (b) (6) TOLEDO OH 463606 (b) (6)

NELSON, MICHAEL, XAVIER UNIV-SYCAMORE (b) (6) PSYCH (b) (6) PHD HOUSE, 3818 WINDING WAY (b) (6) CINCINNATI OH 45207

NORTH COAST 6929 W. 130TH ST, SUITE #500 (b) (6) PSYCH (b) (6) FAMILY FOUNDATION (b) (6) PARMA HEIGHTS OH 44130

NORTHWEST EYE NORTHWEST EYE SURGEONS 614-451-7550 OPTH SURGEONS INC, 2250 NORTH BANK DRIVE (b) (6) COLUMBUS f:614-451-8642 OH 43220

Page 56 of 94 Thursday, October 26, 2017

OAKLEY, MAURICE, (b) (6) (b) (6) OPTH M.D. PSC Scheduler (b) (6) ASHLAND KY 41101 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

OCCHA 3660 SHIRELY RD (330) 781-1808 L-INTERP f:(330) 781-0885 (b) (6) YOUNGSTOWN OH 44502

O'Connell, Haley PSY 1303 Lyons Rd. Building H (b) (6) Psych (b) (6) D (b) (6) Beavercreek OH 45458

OHIO MYOFASCIAL 840 BETHESDA DR BLDG #3 B 800-917-9085 IM, CD, ANC (b) (6) SPECIALISTS INC (b) (6) ZANESVILLE f:(888) 269-4948 OH 43701

Page 57 of 94 Thursday, October 26, 2017

OHIO MYOFASCIAL 716 WEST MARKET ST 800-917-9085 IM, CD, ANC (b) (6) SPECIALISTS INC Scheduler (b) (6) TIFFIN f: OH 44883 (b) (6)

OLYMPUS HEALTH 5810 Pearl Rd. (800) 860-3144 IM PM ORTHO (b) (6) f:(800) 860-3144 (b) (6) Parma OH 44130

Address Phone Speciality Email Vendor Name Vendor Number

OLYMPUS HEALTH 743 S. Byrne Rd (419) 704-0061 IM, OR, PM (b) (6)

(b) (6) Toledo f: OH 43609

OLYMPUS HEALTH 1036 Mt. Vernon Ave. (740) 389-5151 IM, OR, PM (b) (6)

(b) (6) Marion f: OH 43302

Page 58 of 94 Thursday, October 26, 2017

OLYMPUS HEALTH 773 South Broadway (800) 860-3144 IM, OR, PM (b) (6)

f:(800) 860-3144 Scheduler (b) (6) Geneva OH 44041 (b) (6)

ONAMUSI, FREEDOM CHIROPRACTIC (419) 222-9410 IM, PED, CD [email protected] BABATUNDE 420 W RUSSELL RD (b) (6) SIDNEY f:(419) 222-6175 OH 45365

Onamusi, Babatunde (b) (6) (419) 222-9410 IM, CD, Ortho, [email protected] PED (b) (6) Lima f:(419) 222-6175 OH 45805

Address Phone Speciality Email Vendor Name Vendor Number

ONAMUSI, Teeters Chiropractic 1353 (419) 222-9410 IM, CARDIO, [email protected] BABATUNDE MD Woodman Dr. ORTHO, PEDS. PHYS MED (b) (6) Dayton f:(419) 222-6175 OH 45432

Page 59 of 94 Thursday, October 26, 2017

ONAMUSI, (b) (6) (419) 785-4274 CD, IM, ORTHO, [email protected] BABTUNDE, M.D. PED, ANC Scheduler (b) (6) DEFIANCE f:(419) 222-6175 OH 43512 (b) (6)

OSU East 181 Taylor Ave (614) 257-2138 Anc (b) (6)

(b) (6) Columbus f:(614) 366-9595 OH 43203

OSU Internal 700 Ackerman Rd Suite 270 (614) 685-2772 INTERP Medicine LLC (b) (6) Columbus f:(614) 685-5789 OH 43202

OZA & OZA 1100 S MAIN ST. SUITE 203 937-222-3544 IM, ANC [email protected] f:937-222-7122 (b) (6) DAYTON OH 45409

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 60 of 94 Thursday, October 26, 2017

PAWLOSKI, 4930 N HOLLAND SYLVANIA (b) (6) Psych (b) (6) BRITHANY, PSYD RD STE B Scheduler (b) (6) SYLVANIA OH 43560 (b) (6)

PEDIATRIC 555 S. 18th St; Suite 4C (614) 241-5992 OPTH (b) (6) OPTHAMOLOGY ASSOCIATES (b) (6) Columbus f:(614) 241-5232 OH 43205

PEMA, ROBERT, D.O. TOTAL CARE ENT 4488 W. (614) 853-1950 ENT [email protected] BROAD ST. (b) (6) COLUMBUS f:(614) 853-1951 OH 43228

PERRY, JOSEPH, PHD COOK PROF BLDG 1826 S (b) (6) PSYCH (b) (6) MAIN ST (b) (6) AKRON OH 44301

Page 61 of 94 Thursday, October 26, 2017

PICKHOLTZ, 24100 CHAGRIN BLVD. SUITE (b) (6) PSYCH (b) (6) HERSCHEL, ED.D 120 Scheduler (b) (6) BEACHWOOD OH 44122 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

PLONA, RANDY DO (b) (6) (b) (6) IM, PM, ANC (b) (6)

(b) (6) Orrville OH 44667

POWERS, JAMES, 340 E. TOWN ST. STE 700 (b) (6) PM, ANC (b) (6) M.D. (8TH FLOOR) (b) (6) COLUMBUS OH 43215

PRECISION PO BOX 74289 866-439-9184 INTERP RADIOLOGY (b) (6) CLEVELAND f: OH 44194

Page 62 of 94 Thursday, October 26, 2017

PRO MEDICAL 8401 CLAUDE THOMAS RD (419) 297-6766 ENT-Danielle (b) (6) MIDWEST, LLC #27 Gorsky Scheduler (b) (6) FRANKLIN f:(937) 806-3079 OH 45005 (b) (6)

PRO MEDICAL 120 Sturges Ave. Suite # 5 (419) 297-6766 IM (b) (6) MIDWEST, LLC (b) (6) Mansfield f:(937) 806-3079 OH 44907

Address Phone Speciality Email Vendor Name Vendor Number

PRO MEDICAL 68 W. Church St. Suite 104 (419) 297-6766 IM (b) (6) MIDWEST, LLC (b) (6) Newark f:(937) 640-1452 OH 43055

PROFESSIONAL FORT HAMILTON HOSPITAL (614) 513-8724 INTERP RADIOLOGY INC 1010 CEREAL AVE #311 (b) (6) HAMILTON f:(513) 867-2840 OH 45011

Page 63 of 94 Thursday, October 26, 2017

PROVAZNIK, (b) (6) (b) (6) IM, PED, CD, (b) (6) DAVID, D.O. ANC Scheduler (b) (6) WHEELERSBURG OH 45694 (b) (6)

PULMONARY 2600 W TUSCARAWAS RD 330-452-8844 ANC [email protected] PHYSICIANS STE 100 om (b) (6) CANTON f:330-452-7012 OH 44708

QUEST 7451 W RIDGEWOOD DR 440-842-8122 ANC DIAGNOSTICS (b) (6) PARMA f:440-842-4789 OH 44129

Address Phone Speciality Email Vendor Name Vendor Number

QUINN, RUTH, SLP 10133 SPRINGFIELD PIKE STE (b) (6) SLP (b) (6) D (b) (6) CINCINNATI OH 45215

Page 64 of 94 Thursday, October 26, 2017

RADIOLOGY P O BOX 250 (740) 452-9087 ANC-INTERP ASSOCIATES OF SEO Scheduler (b) (6) ZANESVILLE f: OH 43702 (b) (6)

RAINBOW 414 E FIFTH ST 330-386-3844 PSYCH info@rainbowcounselingce COUNSELING nter.com (b) (6) E LIVERPOOL f:330-386-4129 OH 43920

Rainbow Counseling Ctr 380 Summit Ave. Suite 202 (330) 386-3844 Psych info@rainbowcounselingce Inc nter.com (b) (6) Steubenville f:(330) 386-4129 OH 43952

RAITER, KRISTIN, SLP (b) (6) (b) (6) SLP (b) (6)

(b) (6) MARYSVILLE OH 43040

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 65 of 94 Thursday, October 26, 2017

RAMACHANDRAN, (b) (6) (b) (6) PED canton.pediatrics@hotmail. com VIDHYA MD Scheduler (b) (6) CANTON OH 44720 (b) (6)

RAY, GARY, M.D. FORT HAMILTON HOSPITAL 513-867-2730 PM, ANC (b) (6) 1010 CEREAL AVE #311 (b) (6) HAMILTON f:513-867-2840 OH 45013

REECE, JOHN, PSYD 1110 MORSE RD STE 218 (b) (6) PSYCH (b) (6)

(b) (6) COLUMBUS OH 43229

REECE, JOHN, PSYD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) NEWARK OH 43055

REECE, JOHN, PSYD (b) (6) (b) (6) PSYCH

(b) (6) LANCASTER OH 43130

Page 66 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

RESOLUTE PO BOX 532 (419) 244-8377 SL-INTERP, L- INTERPRETING, INTERP LLC TOLEDO f:(419) 534-9828 (b) (6) (b) (6) OH 43697

RINDSBERG, JEFF, 25200 CHAGRIN BLVD SUITE PSYCH (b) (6) PSYD 105 (b) (6) BEACHWOOD (b) (6) OH 44122

RIVERSIDE 3525 Olentangy River Rd. (614) 340-7747 ANC-INTERP RADIOLOGY & INTERVENTIONAL ASSOCS (b) (6) Columbus f:(614) 340-7742 OH 43214

Robert Pema, DO OSUP OTALARYNOLOGY (614) 853-1950 ENT CAREPOINT EAST 543 Taylor Ave.; 2nd Floor (b) (6) Columbus f:(614) 853-1951 OH 43203

Page 67 of 94 Thursday, October 26, 2017

ROBIE, KAREN PHD 4930 N HOLLAND-SYLVANIA RD (b) (6) PSYCH (b) (6) STE B Scheduler (b) (6) SYLVANIA OH 43560 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

ROSENTHAL, JAMES WILDWOOD OFFICE PARK (b) (6) PSYCH PSY D 1006 N UNIVERSITY BLVD (b) (6) MIDDLETOWN OH 45042

SAGHAFI, DARIUSH, 6681 RIDGE RD SUITE 300 (b) (6) IM, NEURO, (b) (6) M.D. (b) (6) PARMA OH 44129

SARVER, GARY, PHD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) ATHENS OH 45701

Page 68 of 94 Thursday, October 26, 2017

SCHMIDTGOESSLIN (b) (6) (b) (6) PSYCH G, NANCY, PHD (b) (6) Scheduler

(b) (6) CINCINNATI OH 45238 (b) (6)

SCHULZ, GEORGE, 2100 East High St. Suite 110 (b) (6) PSYCH (b) (6) PHD (Governor's Manor) (b) (6) SPRINGFIELD OH 45505

Address Phone Speciality Email Vendor Name Vendor Number

SCIOTO CAMPUS (b) (6) (b) (6) ANC f: (b) (6) PORTSMOUTH OH 45662

SCIOTO CAMPUS (b) (6) (b) (6) ANC (b) (6) PORTSMOUTH OH 45662

Page 69 of 94 Thursday, October 26, 2017

SCIOTO CAMPUS (b) (6) (b) (6) ANC f: (b) (6) PORTSMOUTH OH 45662 (b) (6)

SCIOTO CAMPUS (b) (6) (b) (6) ANC (b) (6) PORTSMOUTH OH 45662

SCIOTO PAINT 4449 SR 159 PO BOX 6179 (b) (6) FAC VALLY MHC (b) (6) CHILLICOTHE OH 45601

Address Phone Speciality Email Vendor Name Vendor Number

SED, CHAD PHD (b) (6) (b) (6) PSYCH (b) (6) OR (b) (6)

(b) (6) Portsmouth OH 45662

Page 70 of 94 Thursday, October 26, 2017

Sed, Chad, PhD (b) (6) (b) (6) Psych (b) (6) Scheduler (b) (6) Chillicothe OH 45601 (b) (6)

SELLA, GABRIEL, M.D. 92 N FOURTH ST STE 12 (b) (6) IM, CD, ANC (b) (6) (b) (6) MARTINS FERRY OH 43935

SEXTON, RICHARD (b) (6) (b) (6) Psych (b) (6) PH D (b) (6) CINCINNATI f:

OH 45208

SEXTON, RICHARD 1159 LYONS RD BLDG E (b) (6) Psych (b) (6) PH D (b) (6) CENTERVILLE f: OH 45458

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 71 of 94 Thursday, October 26, 2017

SEXTON, RICHARD 401 CENTER ST STE B (b) (6) PSYCH (b) (6) PHD Scheduler 401 CENTER ST STE B (b) (6) IRONTON f: OH 45638 (b) (6)

SIOSON, EULOGIO, 4200 WARRENSVILLE CTR RD, (b) (6) IM, CD, ANC (b) (6) M.D. OHIO UNIVERSITY-MEDICAL BLDG STE 320 (b) (6) WARRENSVILLE HGTS OH 44122

SIPPS, GARY, PHD 71 WEST AVE STE 3 (b) (6) PSYCH (b) (6) (b) (6) TALLMADGE OH 44278

SMITH, MARGARET, 6100 CHANNINGWAY BLVD (b) (6) PSYCH (b) (6) PHD STE 506 (b) (6) COLUMBUS OH 43232

Page 72 of 94 Thursday, October 26, 2017

SMITH, RONALD, 5321 MEADOW LN CT #5 (b) (6) PSYCH (b) (6) PHD Scheduler (b) (6) ELYRIA OH 44035 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

SOURS, FLOYD, M.A. (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) ZANESVILLE OH 43701

SOUTH POINTE DR SIOSON, S. POINTE BLDG ANC HOSPITAL A #320, 4200 WARRENSVILLE CTR RD (b) (6) WARRENSVILLE HGTS OH 44112

SOUTH POINTE 4180 WARRENSVILLE CENTER ANC HOSPITAL RD (b) (6) WARRENSVILLE HGTS f: OH 44122

Page 73 of 94 Thursday, October 26, 2017

SOUTHERN OHIO PO BOX 643933 (740) 356-7547 ANC-INTERP RADIOLOGIST Scheduler (b) (6) COLUMBUS f:(740) 356-6170 OH 45624 (b) (6)

Spader, Michelle PSY 6260 S. Sunbury Rd. Suite 5 (b) (6) Psych contact@spaderpsychology. D com (b) (6) Westerville OH 43081

Address Phone Speciality Email Vendor Name Vendor Number

SPANISH AMERICAN 4407 LORAIN AVE 216-961-2100 L-Interp COMMITTEE (b) (6) CLEVELAND f:216-961-3305 OH 44113

Sparks Psychological 3951 W. Franklin St. #4 (513) 297-3455 Psych sparksofficemanager@gmail Services .com (b) (6) Bellbrook f:(513) 297-7594 OH 45305

Page 74 of 94 Thursday, October 26, 2017

SPARKS 8118 Corporate Way Suite 121 (513) 297-3455 Psych sparksofficemanager@gmail com PSYCHOLOGICAL Scheduler SERVICES, LLC (b) (6) Mason f:(513) 297-7495 OH 45040 (b) (6)

Sparks Psychological 8118 Corporate Way, Suite 121 (513) 297-3455 Psych (b) (6) Services, LLC (b) (6) Mason f:(513) 297-7594 OH 45040

SPINDLER, JAMES, (b) (6) (b) (6) FAC (b) (6) M.S. (b) (6) CAMBRIDGE OH 43725

Address Phone Speciality Email Vendor Name Vendor Number

SPINDLER, JAMES, (b) (6) (b) (6) PSYCH (b) (6) M.S. (b) (6) LORAIN OH 44052

Page 75 of 94 Thursday, October 26, 2017

SPINDLER, JAMES, 927 WHEELING AVE STE 104 (b) (6) PSYCH (b) (6) M.S. Scheduler (b) (6) CAMBRIDGE OH 43725 (b) (6)

SPRINGFIELD 100 Medical Center Dr. (937) 523-1651 ANC REGIONAL MED CTR (b) (6) Springfield f:(937) 523-1080 OH 45504

SPRINGFIELD 100 Medical Center Dr. (937) 523-1080 ANC REGIONAL MEDICAL CENTER (b) (6) Springfield f:(937) 523-1959 OH 45504

ST LUKES HOSPITAL PATIENT REGISTRATION 5901 (419) 893-5927 ANC MONCLOVA RD (b) (6) MAUMEE f:(419) 897-8444 OH 43537

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 76 of 94 Thursday, October 26, 2017

ST RITA'S MEDICAL 730 W MARKET ST (419) 226-9132 ANC CENTER Scheduler (b) (6) LIMA f:419-226-9657 OH 45801 (b) (6)

ST RITA'S MEDICAL 730 W MARKET ST (419) 226-9132 ANC CENTER (b) (6) LIMA f: OH 45801

ST. LUKES HOSPITAL 5901 MONOCLOVA RD 419-893-5927 f:419- ANC 891-8018 (b) (6) MAUMEE OH 43537

STEINHOFF, (b) (6) (b) (6) PSYCH (b) (6) WILLIAM, M.A. (b) (6) POINT PLEASANT W 45631 V

STINSON, BOB, PSYD 20 S. THIRD STREET SUITE 210 (b) (6) PSYCH

(b) (6) COLUMBUS OH 43215

Page 77 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

SUDHIR DUBEY PSY CENTER FOR INTEGRATED (614) 568-7101 PSYCH (b) (6) D HEALTH 484 S MILLER RD STE Scheduler 201 (b) (6) FAIRLAWN f:(614) 568-7103 OH 44333 (b) (6)

SUDHIR DUBEY PSY (b) (6) (b) (6) Psych (b) (6) D (b) (6) Ontario OH 449069

SUDHIR DUBEY PSY 2040 Brice Rd, Ste 160 (b) (6) Psych (b) (6) D (b) (6) Reynoldsburg OH 43068

Swearingen, T 605 S. Trimble Rd. Suite D (b) (6) Psych (b) (6) Rodney, PH D (b) (6) Mansfield OH 44906

Page 78 of 94 Thursday, October 26, 2017

Swearingen, T (b) (6) (b) (6) Psych (b) (6)

Rodney, PH D Scheduler (b) (6) Zanesville OH 43701 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

SWEARINGEN, T 6877 N HIGH ST STE 305 (b) (6) FAC (b) (6) RODNEY, PHD (b) (6) COLUMBUS OH 43085

SWEARINGEN, T 6877 N HIGH ST STE 305 (b) (6) PSYCH (b) (6) RODNEY, PHD (b) (6) Worthington OH 43085

SWEARINGEN, T 125 EXECUTIVE DR STE 201 (b) (6) PSYCH (b) (6) RODNEY, PHD (b) (6) MARION OH 43302

Page 79 of 94 Thursday, October 26, 2017

Swearingen, T. (b) (6) (b) (6) Psych (b) (6)

Rodney Ph.D. Scheduler (b) (6) Chillicothe OH 45601 (b) (6)

Swearingen, T. (b) (6) (b) (6) PSYCH (b) (6) Rodney, PH D (b) (6) Mt. Vernon OH 43050

Address Phone Speciality Email Vendor Name Vendor Number

SWIFT, ADRIENNE, 8080 BECKETT CTR DR STE (b) (6) PSYCH (b) (6) PHD 313 (b) (6) WEST CHESTER OH 45069

T C HOBBS & 4937 WEST BROAD ST, SUITE 614-544-2301 INTERP ASSOCIATES 302 (b) (6) COLUMBUS f: OH 43228

Page 80 of 94 Thursday, October 26, 2017

TANLEY, JAMES PHD 4041 N HIGH ST 300P (b) (6) PSYCH (b) (6)

(b) (6) COLUMBUS (b) (6) OH 43214

TANLEY, JAMES PHD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) CHILLICOTHE OH 45601

TANLEY, JAMES PHD (b) (6) (b) (6) PSYCH (b) (6)

(b) (6) DELAWARE OH 43015

Address Phone Speciality Email Vendor Name Vendor Number

THE SPEECH AND 1120 N MEMORIAL DR (740) 277-7882 SLP thespeechlanguagepath@ya LANGUAGE PATH hoo.com (b) (6) LANCASTER f:(614) 522-6750 OH 43130

Page 81 of 94 Thursday, October 26, 2017

THE SPEECH AND 1440 ROCKSIDE RD SUTIE 320 (614) 505-7330 SLP thespeechlanguagepath@ya hoo.com LANGUAGE PATH Scheduler (b) (6) PARMA f:(614) 522-6750 OH 44134 (b) (6)

THE SPEECH AND 43 N THIRD ST (614) 505-7330 SLP (b) (6) LANGUAGE PATH (b) (6) MANSFIELD f:(614) 522-6750 OH 44902

THE SPEECH AND 103 LUCASVILLE-MINFORD RD (614) 505-7330 SLP thespeechlanguagepath@ya LANGUAGE PATH hoo.com (b) (6) LUCASVILLE f:(614) 522-6750 OH 45648

THE SPEECH AND 70 BIRCH ALLEY SUITE 240 (614) 556-3366 SLP LANGUAGE PATH BUILDING B (b) (6) BEAVERCREEK f:(614) 522-6750 OH 45440

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 82 of 94 Thursday, October 26, 2017

THE SPEECH AND 7100 N. HIGH ST. SUITE 203 (614) 505-7330 FAC thespeechlanguagepath@ya hoo.com LANGUAGE PATH Scheduler (b) (6) COLUMBUS f:(614) 522-6750 OH 43085 (b) (6)

THE SPEECH AND 650 W MARKET ST (614) 505-7330 SLP thespeechlanguagepath@ya LANGUAGE PATH hoo.com (b) (6) LIMA f:(614) 522-6750 OH 45801

THOMAS EYECARE, 3619 PARK EAST DR SUITE 306 (216) 292-9150 OPTH DRTHOMAS@THOMASE LTD YECARE.ORG (b) (6) BEACHWOOD f:(216) 292-9159 OH 44122

THOMAS M EVANS, THE CENTER FOR CLINICAL (440) 263-0266 PSYCH (b) (6) PHD PSYCHOLOGY 31674 Center Ridge Rd Ste 103 (b) (6) NORTH RIDGEVILLE f:(440) 348-2362 OH 44039

Page 83 of 94 Thursday, October 26, 2017

THORTON, LISA, 4041 N HIGH ST STE 300 I (b) (6) PSYCH (b) (6) PHD Scheduler (b) (6) COLUMBUS OH 43214 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

TOGLIATTI- (b) (6) (b) (6) PM, ORTHO, (b) (6) TRICKETT, ANC KIMBERLY, M.D. (b) (6) PARMA OH 44129

TRI - STATE 1649 BRICE RD STE B (800) 929-8766 IM, PEDS, ANC (b) (6) OCCUPATIONAL MEDICINE (b) (6) REYNOLDSBURG f:(304) 525-0664 OH 43068

TRI - STATE 5510 PEARL ROAD SUITE 205 (800) 929-8766 IM, PED, ANC (b) (6) OCCUPATIONAL MEDICINE (b) (6) CLEVELAND f:(304) 525-0664 OH 44129

Page 84 of 94 Thursday, October 26, 2017

TRI - STATE 400 E STATE ST 800-929-8766 IM, PED, ANC (b) (6) OCCUPATIONAL Scheduler MEDICINE (b) (6) ATHENS f:304-525-0664 OH 45701 (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

TRI - STATE 3 ROSEMAR CIRCLE SUITE C 800-929-8766 IM, CD, NE, (b) (6) OCCUPATIONAL ORTHO, ANC MEDICINE (b) (6) PARKERSBURG f:304-525-4231 W 26104 V

TRI - STATE 4417 N HOLLAND-SYLVANIA (800) 929-8766 IM, PED, ANC (b) (6) OCCUPATIONAL RD SUITE C MEDICINE (b) (6) TOLEDO f:(304) 525-4231 OH 43623

Page 85 of 94 Thursday, October 26, 2017

TRI - STATE FAMILY HEALTH CARE 2057 S 800-929-8766 IM, CD, PED, (b) (6) OCCUPATIONAL LIMESTONE E ANC Scheduler MEDICINE (b) (6) SPRINGFIELD f:304-525-0664 OH 45505 (b) (6)

TRI - STATE CCMH DOCTOR'S CLINIC 800-929-8766 IM, PED, ANC (b) (6) OCCUPATIONAL 1523 WALNUT STREET MEDICINE (b) (6) COSHOCTON f:740-623-4145 OH 43812

Address Phone Speciality Email Vendor Name Vendor Number

TRI - STATE 46141 National Rd. - Bisbocci 800-929-8766 IM, CD, ORTHO, (b) (6) OCCUPATIONAL Chiropractic ANC, PEDS MEDICINE (b) (6) ST CLAIRSVILLE f:304-525-0664 OH 43950

Page 86 of 94 Thursday, October 26, 2017

TRI - STATE 702 6TH AVE (800) 929-8766 IM/ORTHO (b) (6) OCCUPATIONAL MEDICINE Scheduler (b) (6) HUNTINGTON f:(304) 525-0664

W 25701 V (b) (6)

TRI STATE 1069 DELAWARE AVENUE (800) 929-8766 IM, PEDS, PE, (b) (6) OCCUPATIONAL (DELEX ONE BUILDING) ANC MEDICINE (b) (6) MARION f:(304) 525-0664 OH 43302

TRI STATE 872 OHIO PIKE (800) 929-8766 IM, PM, ORTHO, (b) (6) OCCUPATIONAL PEDS MEDICINE (b) (6) CINCINNATI f:(304) 525-0664 OH 45245

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 87 of 94 Thursday, October 26, 2017

TRI-STATE 51 STATE STREET (800) 929-8766 IM, PM, ANC OCCUPATIONAL Scheduler (b) (6) STRUTHERS f:(304) 525-0664 OH 44471 (b) (6)

TWEHUES, JESSICA 1487 N. High St., Suite 500 (b) (6) PSYCH (b) (6)

(b) (6) HILLSBORO OH 45133

TWEHUES, JESSICA, (b) (6) (b) (6) PSYCH (b) (6) PSYD (b) (6) CINCINNATI OH 45255

TWEHUES, JESSICA, 311 NILLES RD STE A (b) (6) PSYCH (b) (6) PSYD (b) (6) FAIRFIELD OH 45014

UHC VASCULAR GSH PULMONARY SVC 513-569-5027 INTERP (b) (6) (ATTN: (b) (6) 375 DIXMYTH RD (b) (6) CINCINNATI f: OH 45220

Page 88 of 94 Thursday, October 26, 2017

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

UJCICH, JENNIFER MARION PUBLIC LIBRARY (b) (6) SLP (b) (6) SLP 2ND FLOOR CONFERENCE Scheduler ROOM 445 EAST CHURCH STREET (b) (6) MARION f: OH 43302 (b) (6)

US COMMITTEE 815 SUPERIOR AVE E STE 100 (216) 781-4560 L-INTERP FOR REFUGEES AND IMMIGRANTS (b) (6) CLEVELAND f:(216) 781-4565 OH 44114

US TOGETHER 2021 E DUBLIN GRANVILLE 614-581-4357 L-INTERP RD., SUITE 190 (b) (6) COLUMBUS f:614-737-3487 OH 43229

Page 89 of 94 Thursday, October 26, 2017

VALLEY P O BOX 6825 (304) 233-9314 ANC-INTERP RADIOLOGISTS Scheduler (b) (6) WHEELING f: W 26003 V (b) (6)

Address Phone Speciality Email Vendor Name Vendor Number

VANESTENBERG, 5815 MARKET ST Suite #5 (b) (6) PSYCH (b) (6) ANDREA PHD (b) (6) BOARDMAN OH 44512

VITOLS, AIVARS, ORTHOPEDIC ASSOCS OF SW (937) 415-9117 ORTHO, ANC (b) (6) D.O. OHIO 4160 LITTLE YORK RD STE 10 (b) (6) DAYTON f:(937) 439-0362

OH 45414

VOCALINK 405 W 1st St (937) 401-1460 L-INTERP (b) (6) f:(866) 264-1163 (b) (6) Dayton OH 45402

Page 90 of 94 Thursday, October 26, 2017

WARREN 3921 MARKET ST (330) 856-3300 OPTH (b) (6) OPHTHALMOLOGY Scheduler ASSOCIATES (b) (6) WARREN f:(330) 856-4539 OH 44484 (b) (6)

WARREN 3893 E MARKET ST 330-856-4000 ENT OTOLOGICAL, INC (b) (6) WARREN f:330-609-9910 OH 44484

Address Phone Speciality Email Vendor Name Vendor Number

WATKINS, DANIEL, 3450 W CENTRAL AVE STE (b) (6) PSYCH (b) (6) PHD 350 (b) (6) TOLEDO OH 43606

WAX, MITCHELL, (b) (6) (b) (6) PSYCH (b) (6) PHD (b) (6) LAKEWOOD OH 44107

Page 91 of 94 Thursday, October 26, 2017

Welden Medical LLC Eastside Urgent Care 872 Ohio (513) 947-9115 IM, ANC, Ortho (b) (6) Pike Scheduler (b) (6) Cincinnati f:(513) 752-6695 OH 45245 (b) (6)

Wellcare 241 N. Superior St. Ste. 301 (419) 214-3220 IM, PM, ST (b) (6) f:(859) 987-0839 (b) (6) Toledo OH 43604

WHEELING SPEECH PATHOLOGY DEPT 304-243-370 SLP (b) (6) HOSPITAL 1021 MT. DECHANTAL RD. #2 (b) (6) WHEELING f:304-243-3901 W 26003 V

Address Phone Speciality Email Vendor Name Vendor Number

Whitlow PhD, Natalie HUMANISTIC COUNSELING (573) 525-6060 Psych (b) (6) CENTER 26250 EUCLID AVE STE 527 (b) (6) Euclid f:(216) 671-7543 OH 44132

Page 92 of 94 Thursday, October 26, 2017

WIERWILLE, JENA L Van Wert Med Arts Bldg, 140 (b) (6) PSYCH (b) (6) Fox Rd., Ste. 301 Scheduler (b) (6) Van Wert f: OH 45891 (b) (6)

Wierwille, Jena L. (b) (6) (b) (6) PSYCH (b) (6) f: (b) (6) Van Wert OH 45891

WILSON MEMORIAL 315 W MICHIGAN ST (937) 492-7296 ANC HOSPITAL (b) (6) SIDNEY f:(937) 498-5544 OH 45365

WUEBKER, 2444 CABLE CT STE H (b) (6) PSYCH (b) (6) MICHAEL, PHD (b) (6) LIMA OH 45805

Address Phone Speciality Email Scheduler / Vendor Name Vendor Number Pro

Page 93 of 94 Thursday, October 26, 2017

WUEBKER, 334 GODFREY AVE STE A (b) (6) PSYCH (b) (6) MICHAEL, PHD Scheduler (b) (6) CELINA OH 45822 (b) (6)

YOUNGSTOWN 6614 SOUTHERN BLVD 330-726-8855 SL-INTERP HEARING / SPEECH CENTER (b) (6) YOUNGSTOWN f:330-726-9182 OH 44512

Z A/P Screen In f: (b) (6)

ZAKE, JEROME, PHD 3454 OAK ALLEY CT STE 305 (b) (6) PSYCH (b) (6)

(b) (6) TOLEDO OH 43606

Page 94 of 94 Thursday, October 26, 2017

Ohio FY 2017 Key Providers

ID NUMBER VENDOR NAME TOTAL PAID PSYCHOLOGICAL MEDICAL COMMENTS. FORPSYCH CORPORATION $1,556,573.00 $1,556,573.00 (b) (6) MEDICAL & OCCUPATIONAL HEALTH $758,357.00 $758,357.00 MARTIN FRITZHAND MD TRI-STATE OCCUPATIONAL MED INC $588,259.00 $588,259.00 IMA EVALUATIONS OF OHIO INC $450,090.00 $120,391.00 $329,699.00 MEDICAL EVALUATION SERV INC $368,702.25 $368,702.25 X REF REC INC J JOSEPH KONIECZNY, PHD $314,303.00 $314,303.00 CONSULTING PSYCHOLOGY INC $299,644.00 $299,644.00 DRS LEIDAL & MAGLEBY FARRELL NELSON SERVICES INC $283,302.00 $283,302.00 LEE HOWARD OFFICE JOHN S REECE $258,841.00 $258,841.00 JAMES C TANLEY, PHD $255,753.00 $255,753.00 T RODNEY SWEARINGEN PHD $255,469.00 $255,469.00 REC INC $243,430.00 $243,430.00 X REF MED EVAL SVCS RICHARD SEXTON, PHD $227,978.00 $227,978.00 NANCY SCHMIDTGOESSLING, PHD $227,614.00 $227,614.00 ADVANCED INJURY MANAGEMENT SC $225,643.00 $225,643.00 SUDHIR DUBEY PSYD FORENSIC PSYCHOLOGICAL CENTER $203,611.00 $203,611.00 HEMISPHERIC PSYCHOLOGICAL $195,433.00 $195,433.00 MARK HAMMERLY PHD MICHAEL W FAUST $193,304.00 $193,304.00 DOROTHY A BRADFORD, MD $184,191.50 $184,191.50 NORMAN L BERG, PHD $175,605.00 $175,605.00 THE SPEECH LANGUAGE PATH LLC $173,037.50 $173,037.50 JOPPA CAPITAL VENTURES INC $171,545.00 $171,545.00 CENTER FOR CLINICAL PSYCHOLOGY $171,318.00 $171,318.00 WELLCARE DISABILITY LLC $161,258.00 $161,258.00 BABATUNDE ONAMUSI, MD $160,157.00 $160,157.00 JESSICA TWEHUES PSYD $160,148.00 $160,148.00 MARC E MILLER $158,584.00 $158,584.00 LIBERTY MEDICAL ASSESSMENT LLC $156,479.00 $156,479.00 TOTAL $8,578,629.25 $5,283,514.00 $3,295,115.25 Oklahoma FY 2017

Vendor ID letter Providers name Clinic name City state Specialty

ABDOLKARIM KHORASANCHIAN ABDOLKARIM KHORASANCHIAN MD MD McAlester OK Cardio (b) (6) Abhilash Davlapur MD Sooner Medical Services OKC OK Internist ABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK Speech ABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK Speech ADEL MALATI MD ADEL MALATI MD Okmulgee OK Internist ADEL MALATI MD ADEL MALATI MD Okemah OK Internist Akram Abraham MD Abraham Medical Clinic Hollis OK Internist Alan Miner DO Midwest CES Ada OK Internist Alan Miner DO Midwest CES Ardmore OK Internist Alan Miner DO Midwest CES McAlester OK Internist Alan Miner DO Midwest CES Muskogee OK Internist

ALDEN CLINICAL EVALUATION SVCS ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology Alison Hansen-Pitts OD The Eye Institute Inc Tulsa OK Optometry Allison Craig SLP Discovery Pediatric Therapy Poteau OK Speech Alyssa Rippy PhD Advanced Pain Specialist Tulsa OK Psychology Amy Ashcraft ARNP Abraham Medical Clinic Hollis OK Internist Andrea Jones MD Sooner Medical Services OKC OK Internist Andrea Miller MD Eve Medical Services Enid OK Internist Andrea Miller MD Eve Medical Services Weatherford OK Internist Andrea Miller MD Eve Medical Services Bartlesville OK Internist Andrea Miller MD Eve Medical Services Miami OK Internist Andrew White MD Sooner Medical Services OKC OK Internist Aneri Gupta-Lim Sooner Medical Services OKC OK Internist ANIL PATEL MD Dean McGee Eye Institute OKC OK Optometry Anna M Homen PhD Moore Counseling Center Moore OK Psychology Anna M Homen PhD Moore Counseling Center Moore OK Psychology Arjun Ghodasara MD Midtown Medical Associates LLC Tulsa OK Internist Arkansas Occupational Health Arkansas Occupational Health Clinic Springdale AR Lab/Xray/PFS Arkansas Occupational Health Arkansas Occupational Health Clinic Van Buren AR Lab/Xray/PFS ASHOK KACHE MD ASHOK KACHE MD Tulsa OK EMG ASHOK KACHE MD ASHOK KACHE MD Tulsa OK Internist AUDIOLOGY OF TULSA - Lang, Nitzel, Russ, Worth, Alred AUDIOLOGY OF TULSA Tulsa OK Audiology BAILEY RUNKLES DO Midtown Medical Associates LLC Tulsa OK Internist BALA KRISHNA V ARABOLU MD BALA KRISHNA V ARABOLU MD Durant OK Pediatrics BENJAMIN ROBERTS DO Midtown Medical Associates LLC Tulsa OK Internist BETTY J FEIR PHD PC BETTY J FEIR PHD PC Texarkana TX Psychology Beverly Cooper ARNP Abraham Medical Clinic Hollis OK Internist Blake Carlisle OD Blake Carlisle OD Fairview OK Optometry BRAD LISTON DO Liston LLC Ponca City OK Internist BRADLEY K FARRIS MD - Neuro Opthamologist Dean McGee Eye Institute OKC OK Optometry Brandi Duncan SLP Discovery Pediatric Therapy Poteau Ok SLP BRANDI WOFFORD SLP Wofford Speech Therapy Tulsa OK Speech BRIAN BIRDWELL MD (LAWTON) BRIAN BIRDWELL MD (LAWTON) Lawton OK Internist Brian Snider PhD Psychological Services of Tulsa Tulsa OK Psychology Bronwyn Howard ARNP Main Street Family Clinic Stroud OK Internist Bryan Peck MD Eve Medical Enid OK Internist Bryan Peck MD Eve Medical Weatherford OK Internist BILINGUAL COMMUNICATION Mariana Navas Bryant SLP POTENTIAL OKC OK Speech Cameron Smith DO H&H Exams LLC Tulsa OK Internist Catherine Fusilier MD Sooner Medical Services OKC OK Internist CE Provider Services CE Provider Services Amarillo TX Internist Charles B Fullenwider MD Midwest CES Ada OK Internist Charles B Fullenwider MD Midwest CES Ardmore OK Internist Charles B Fullenwider MD Midwest CES McAlester OK Internist Charles B Fullenwider MD Midwest CES Muskogee OK Internist CHARLES D TAYLOR MD (OKC) CHARLES D TAYLOR MD (OKC) OKC OK Internist Central Oklahoma Family Medical Charles R Vest MD Center Ada OK Internist Chelsea Berges DO Janza LLC Tulsa OK Internist Christine Beeson DO Janza LLC Tulsa OK Internist CHRISTOPHER CAMPBELL PHD CHRISTOPHER CAMPBELL PHD (LAWTON) (LAWTON) Lawton OK Psychology CHRISTOPHER CAMPBELL PHD CHRISTOPHER CAMPBELL PHD (LAWTON) (LAWTON) Pauls Valley OK Psychology Christopher Thompson DO H & H Exams Tulsa OK Internist CHRISTOPHER L SUDDUTH MD (ADA) Midwest CES Ada OK Internist Christopher L Sudduth MD (Ardmore) Midwest CES Ardmore OK Internist CHRISTOPHER L SUDDUTH MD (MCALESTER) Midwest CES McAlester OK Internist CHRISTOPHER L SUDDUTH MD (MUSKOGEE) Midwest CES Muskogee OK Internist

CINDY L ROBERTS MS CCCA (ENID) CINDY L ROBERTS MS CCCA (ENID) Enid OK Audiology Corey Babb DO Midtown Medical Associates LLC Tulsa OK Internist (b) (6) Corey Matthews DO H & H Exams Tulsa OK Internist CRYSTEN CHEATWOOD DO (TULSA) Midtown Medical Associates LLC Tulsa OK Internist DANA FOLEY PHD (ARDMORE) DANA FOLEY PHD (ARDMORE) Ardmore OK Psychology

DANA GUDGEL MA CCC SLP (TULSA) DANA GUDGEL MA CCC SLP (TULSA) Tulsa OK Psychology DARIO M ESPINA MD (FT SMITH) Arkansas Heart Center Ft Smith AR Cardio

DARRELL L LYNCH PHD (LAWTON) DARRELL L LYNCH PHD (LAWTON) Lawton OK Psychology Dave Kerby PhD Moore Counseling Center Moore OK Psychology David Bishop MD Sooner Medical Services OKC OK Internist DAVID BRINKER MD (OKC) Northwest Eye Physicians OKC OK Optometry DAVID J KING DO (OKC) Quality Medical Clinic OKC OK Internist DAVID WIEGMAN MD (BARTLESVILLE) Eve Medical Bartlesville OK Internist DAVID WIEGMAN MD (MIAMI) Eve Medical Miami OK Internist DEANN M GATTIS Psychological DEANN M GATTIS PHD (NORMAN) Services Norman OK Psychology DEANNA SEVERSON CCC SLP DEANNA SEVERSON CCC SLP Bartlesville OK Speech DENISE LAGRAND PSY D DENISE LAGRAND PSY D (TAHLEQUAH) (TAHLEQUAH) Tahlequah OK Psychology Dennis Morris OD Vision Source Sapulpa OK Optometry Dennis Whitehouse DO Pauls Valley Medical Center Pauls Valley OK Internist DERRISE L GARNER PSY D (MIAMI) Herndon Snider & Associates PC Miami OK Psychology Divya Byragani MD Midtown Medical Associates LLC Tulsa OK Internist

DLO (ADA) - Sooner Medical Diagnostic Laboratory of Oklahoma Ada OK Lab

DLO (ARDMORE) - Sooner Medical Diagnostic Laboratory of Oklahoma Ardmore OK Lab

DLO (CLINTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Clinton OK Lab

DLO (DURANT) - Sooner Medical Diagnostic Laboratory of Oklahoma Durant OK Lab

DLO (EDMOND) - Sooner Medical Diagnostic Laboratory of Oklahoma Edmond OK Lab

DLO (ELK CITY) - Sooner Medical Diagnostic Laboratory of Oklahoma Elk City OK Lab

DLO (ENID) - Sooner Medical Diagnostic Laboratory of Oklahoma Enid OK Lab

DLO (GROVE) - Sooner Medical Diagnostic Laboratory of Oklahoma Grove OK Lab

DLO (Idabel) - Sooner Medical Diagnostic Laboratory of Oklahoma Idabel OK Lab

DLO (LAWTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Lawton OK Lab

DLO (MCALESTER) - Sooner Medical Diagnostic Laboratory of Oklahoma McAlester OK Lab

DLO (MIAMI) - Sooner Medical Diagnostic Laboratory of Oklahoma Miami OK Lab

DLO (MUSKOGEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Muskogee OK Lab

DLO (OKC) - Sooner Medical Diagnostic Laboratory of Oklahoma OKC OK Lab

DLO (SHAWNEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Shawnee OK Lab

DLO (STILLWATER) - Sooner Medical Diagnostic Laboratory of Oklahoma Stillwater OK Lab

DLO (TULSA) - Sooner Medical Diagnostic Laboratory of Oklahoma Tulsa OK Lab Dragos Vesbianu MD Midtown Medical Associates LLC Tulsa OK Internist DUSTIN GANT WARD PHD (MOORE) Moore Counseling Center Moore OK Psychology DUSTIN GANT WARD PHD (MOORE)(IQ) Moore Counseling Center Moore OK Psychology E L JORDAN JR DO PC (JOPLIN) E L JORDAN JR DO PC (JOPLIN) Joplin MO Optometry

Eddie Scott PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology Emily Sullivan SLP Moore Counseling Center Moore OK Speech ERIN RAMSEY SLP Ramsey Speech Pathology PLLC Muskogee OK Speech EVE MEDICAL SERVICES (ENID) EVE MEDICAL SERVICES (ENID) Enid OK PFS EVE MEDICAL SERVICES (MIAMI) EVE MEDICAL SERVICES (MIAMI) Miami OK PFS EVE MEDICAL SERVICES EVE MEDICAL SERVICES (WEATHERFORD) (WEATHERFORD) Weatherford OK PFS Family Vision Clinic (Robert Head, Kyle Head, Kristina Flint) FAMILY VISION CLINIC (LAWTON) Lawton OK Optometry

GAIL POYNER PHD (CHOCTAW)(IQ) GAIL POYNER PHD (CHOCTAW)(IQ) Choctaw OK Psychology GAIL POYNER PHD GAIL POYNER PHD (CHOCTAW)(MSE) (CHOCTAW)(MSE) Choctaw OK Psychology GARY DENSLOW MD (Muskogee) Pediatric Opthalmology Inc Muskogee OK Optometry GARY DENSLOW MD (TULSA) Pediatric Opthalmology Inc Tulsa OK Optometry Integris Cardiovascular Physicians GEORGE S CHRYSANT MD (ALTUS) LLC Altus OK Cardio Integris Cardiovascular Physicians (b) (6) GEORGE S CHRYSANT MD (CHICKASHA) LLC Chickasha OK Cardio Integris Cardiovascular Physicians GEORGE S CHRYSANT MD (ADA) LLC Ada OK Cardio Integris Cardiovascular Physicians GEORGE S CHRYSANT MD (CLINTON) LLC Clinton OK Cardio Integris Cardiovascular Physicians GEORGE S CHRYSANT MD (OKC) LLC OKC OK Cardio GREAT PLAINS REG MEDICAL GREAT PLAINS REG MEDICAL CENTER-ELK CITY CENTER-ELK CITY Elk City OK Lab Guila Hall MD Sooner Medical Services OKC OK Internist GWEN FUENTES MD (ARDMORE) GWEN FUENTES MD (ARDMORE) Ardmore OK Internist HAROLD ZANE DELAUGHTER DO (TULSA) Janza LLC Tulsa OK Internist Healthcare Stat (Corbert Bercier) Healthcare Stat Chickasha OK Internist Healthcare Stat (Dustin Wade) Healthcare Stat Chickasha OK Internist Healthcare Stat (Heather Worden) Healthcare Stat Chickasha OK Internist Healthcare Stat (Lindsey Leehan) Healthcare Stat Chickasha OK Internist Healthcare Stat (Martin Christensen) Healthcare Stat Chickasha OK Internist Healthcare Stat (Shawn Bonilla) Healthcare Stat Chickasha OK Internist Healthcare Stat (Tonya Jones) Healthcare Stat Chickasha OK Internist HEARTS FOR HEARING - (Wolfe, Neumann) HEARTS FOR HEARING OKC OK Audiology HEATHER RANGER PHD (TULSA) HEATHER RANGER PHD (TULSA) Tulsa OK Psychology Hope Burkett DO H&H Exams LLC Tulsa OK Internist Ilse Carrizales PhD Moore Counseling Center Moore OK Psychology INNOVATIVE EXPRESSIONS INNOVATIVE EXPRESSIONS Edmond Ok Speech JACOB AZURDIA MD (Sooner Medical OKC) Sooner Medical Services OKC OK Internist JACOB AZURDIA MD(ENID) Eve Medical Enid OK Internist JACOB AZURDIA MD(WEATHERFORD) Eve Medical Weatherford OK Internist JAMES CHAPMAN MD (GROVE) Oklahoma Heart Institute Grove Ok Cardio JAMES CRUTCHER MD (BARTLESVILLE) Eve Medical Bartlesville Ok Internist JAMES CRUTCHER MD (MIAMI) Eve Medical Miami Ok Internist JAMES H GENTRY DO (ADA) Midwest CES Ada Ok Internist JAMES H GENTRY DO (ARDMORE) Midwest CES Ardmore Ok Internist JAMES H GENTRY DO (MCALESTER) Midwest CES McAlester Ok Internist JAMES H GENTRY DO (MUSKOGEE) Midwest CES Muskogee OK Internist JAMES L BURKE DO (OKC) Quality Medical Clinic OKC OK Internist

JAMES SCOTT PSY D (SHAWNEE) (MSE) Ok Assessment & Therapy Services Shawnee OK Psychology

JAMES SCOTT PSY D (SHAWNEE)(IQ) Ok Assessment & Therapy Services Shawnee OK Psychology JAN S KENT PHD (MIAMI) Herndon Snider & Associates PC Joplin MO Psychology JANA B KLUCK MA CCC SLP (OKC) JANA B KLUCK MA CCC SLP (OKC) OKC OK Speech JANET KATES PHD (OKC) JANET KATES PHD (OKC) OKC OK Psychology Jason Pickard OD Cornerstone Eye Care OKC OK Optometry Jennifer Davis SLP Ramsey Speech Pathology PLLC Muskogee OK Speech JENNIFER LANCASTER PHD (NORMAN)(IQ) Lancaster Psychological Services Norman OK Psychology JENNIFER LANCASTER PHD (NORMAN)(MSE) Lancaster Psychological Services Norman OK Psychology JENNY BENDURE PhD Serinity Mental Health Norman OK Psychology

JEROME M DILLING JR MD (ENID) JEROME M DILLING JR MD (ENID) Enid OK Audiology JERRY CHILDS JR DO (OKC) Quality Medical Clinic OKC OK Internist JERRY D FIRST MD (TULSA) JERRY D FIRST MD (TULSA) Tulsa OK Internist JERRY D WHITE PHD (OKC) JERRY D WHITE PHD (OKC) OKC OK Psychology JOHN B BARRINGER OD (ARDMORE) Vision Source Ardmore OK Optometry JOHN FARAG DO (Eve Medical) Eve Medical Weatherford OK Internist JOHN FARAG DO (Sooner Medical) Sooner Medical OKC OK Internist JOHN J ALPAR MD (AMARILLO) JOHN J ALPAR MD (AMARILLO) Amarillo TX Optometry JOHN RICE DO (CHECOTAH) Payne & Rice Clinic Checotah OK Internist

JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK Psychology

JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK Psychology Johnnie Brasuell APRN Johnnie Brasuell APRN Catoosa OK Internist JOHNSON GOURD MD (MIAMI) Eve Medical Miami OK Internist

JOSE A ALEMPARTE MD (FT SMITH) JOSE A ALEMPARTE MD (FT SMITH) Ft Smith AR Cardio JOSEPH JAMES PSY D (TULSA) (TEST) Christian Family Institute Tulsa OK Psychology JOSEPH JAMES PSY D (TULSA)(MSE) Christian Family Institute Tulsa OK Psychology JUAN MALDONADO MD JUAN MALDONADO MD (ANADARKO) (ANADARKO) Anadarko OK Internist JUAN RANGO MD (ADA) Midwest CES Ada OK Internist JUAN RANGO MD (ARDMORE) Midwest CES Ardmore OK Internist JUAN RANGO MD (MCALESTER) Midwest CES McAlester OK Internist JUAN RANGO MD (MUSKOGEE) Midwest CES Muskogee OK Internist JUSTIN ANDERSON MD (OKC) Quality Medical Clinic OKC Ok Internist Justin Funk OD Premier Eyecare of Enid Enid OK Optometry

KARA RODGERS PSY D (OKC) Brookwood Psychological Services OKC Ok Psychology KATHLEEN A WARD PHD KATHLEEN A WARD PHD (MCALESTER) (MCALESTER) McAlester Ok Psychology (b) (6) KEITH GREEN PHD (OKC) R KEITH GREEN PHD (OKC) OKC Ok Psychology

KENNY A PARIS PHD (TAHLEQUAH) KENNY A PARIS PHD (TAHLEQUAH) Tahlequah Ok Psychology Kent Abernathy DO Midtown Medical Associates LLC Tulsa OK Internist

KEVIN M WHISMAN PSY D (JOPLIN) KEVIN M WHISMAN PSY D (JOPLIN) Joplin MO Psychology Kimi Carson PhD Moore Counseling Center Moore OK Psychology Arkansas Occupational Health Konstantin Berestnev MD Clinic Springdale AR Internist Arkansas Occupational Health Konstantin Berestnev MD Clinic Van Buren AR Internist KRISTI L BRATKOVICH PHD KRISTI L BRATKOVICH PHD (LAWTON) (LAWTON) Lawton OK Psychology Lacy Crissup OD Claremore Eye Associates Claremore OK Optometry LARRY VAUGHT PHD (TULSA) LARRY VAUGHT PHD (TULSA) Tulsa OK Psychology Leah Upton DO Jenks Health Team Jenks Ok Internist Leomar Bautista DO H & H Exams Tulsa OK Internist Lesley Flores SLP Lesley Flores SLP Tulsa OK Speech Levi Armstrong PhD Paris Counseling Center Paris TX Psychology LINDA K CAMERON MA CCC LINDA K CAMERON MA CCC (EDMOND) (EDMOND) Edmond OK Speech M. Said Sadeghi DO Pediatric Opthalmology Inc Tulsa OK Optometry MARK ENGLANDER PHD (MSE) MARK ENGLANDER PHD (MSE) (NORMAN) (NORMAN) Norman OK Psychology MARK ENGLANDER PHD (MSE) MARK ENGLANDER PHD (MSE) (NORMAN) (NORMAN) Norman OK Psychology MARK WOOD MD (OKC) Otologic Medical Clinic OKC OK Audiology MARTIN D BAUTISTA MD (GUYMON) Specialty Clinics Of St Anne PLLC Guymon OK Internist MARY MARGUERITE LANGILLE-HOPPE PSY D (SHAWNEE) Ok Assessment & Therapy Services Shawnee OK Psychology Matthew Heisey APRN Pauls Valley Medical Center Pauls Valley OK Internist MATTHEW PHILIP FEIST MD (ADA) Midwest CES Ada OK Internist MATTHEW PHILIP FEIST MD (ARDMORE) Midwest CES Ardmore OK Internist MATTHEW PHILIP FEIST MD (MCALESTER) Midwest CES McAlester OK Internist Matthew Philip Feist MD (Muskogee) Midwest CES Muskogee OK Internist Matthew Smith DO H & H Exams Tulsa OK Internist MAX CARLISLE OD (FAIRVIEW) MAX CARLISLE OD (FAIRVIEW) Fairview OK Optometry Maxwell Sencherey DO H & H Exams Tulsa OK Internist MCCURTAIN MEMORIAL HOSPITAL- MCCURTAIN MEMORIAL HOSPITAL-PFS PFS Idabel OK PFS MELINDA SHAVER PSY D MELINDA SHAVER PSY D (BARTLESVILLE) (MSE) (BARTLESVILLE) (MSE) Bartlesville OK Psychology MICHAEL KARATHANOS MD MICHAEL KARATHANOS MD (TULSA) (TULSA) Tulsa OK Neurology MICHAEL MCGEE MD (OKC) Otologic Medical Clinic OKC OK Audiology Integris Cardiovascular Physicians MICHAEL SCHIFF MD (PONCA CITY) LLC Ponca City OK Cardio MICHELINE CHRISMAN PSYD MICHELINE CHRISMAN PSYD (NORMAN) (NORMAN) Norman OK Psychology MINOR GORDON PHD MINOR GORDON PHD (CLAREMORE) (CLAREMORE) Claremore OK Psychology MIRACLE GOETZ PSY D (MOORE)(IQ) Moore Counseling Center Moore OK Psychology MIRACLE GOETZ PSY D (MOORE)(MSE) Moore Counseling Center Moore OK Psychology

NANCY FAYE BARTON PHD (TULSA) NANCY FAYE BARTON PHD (TULSA) Tulsa OK Psychology NICK LEE CARROLL DO (TULSA) Midtown Medical Associates LLC Tulsa OK Internist OKEY NWOKOLO MD (OKC) Okey Nwololo MD & Associates OKC OK Pediatrics PAUL J SCHWARTZ PHD (TULSA) PAUL J SCHWARTZ PHD (TULSA) Tulsa OK Psychology PAUL J SCHWARTZ PHD (TULSA) PAUL J SCHWARTZ PHD (TULSA) (TEST) (TEST) Tulsa OK Psychology PAUL S THOMAS MD (MCALESTER) Warren Clinic McAlester OK Psychology Pauls Valley Medical Center Pauls Valley Medical Center Pauls Valley OK X-rays/labs Peggy Gardner ARNP Main Street Family Clinic Stroud OK Internist PETER CIALI PHD (TULSA) Advanced Pain Specialist Tulsa OK Psychology Peter Holm PhD Peter Holm PhD Sherman TX Psychology

PULMONARY PHYSICIANS OF OKC PULMONARY PHYSICIANS OF OKC OKC OK PFS QTC MEDICAL GROUP INC QTC MEDICAL GROUP INC (LAWTON) (LAWTON) Lawton Ok X-ray/labs QTC MEDICAL GROUP INC (OKC) QTC MEDICAL GROUP INC (OKC) OKC Ok X-ray/labs QUALITY MEDICAL CLINIC (OKC)- QUALITY MEDICAL CLINIC (OKC)-PFS/LAB PFS/LAB OKC Ok PFS/Labs RACHEL SMILEY PHD (IQ) (MOORE) Moore Counseling Center Moore Ok Psychology RACHEL SMILEY PHD (MOORE)(MSE) Moore Counseling Center Moore Ok Psychology RAFAEL F OTERO PHD RAFAEL F OTERO PHD (TEXARKANA) (TEXARKANA) Texarkana TX Psychology RAY HAND PHD (OKC) RAY HAND PHD (OKC) OKC OK Psychology Raymond Azadgoli MD Quality Medical Clinic OKC Ok Internist RED RIVER VALLEY RAD & RED RIVER VALLEY RAD & PATHOLGY (PARIS) PATHOLGY (PARIS) Paris TX X-ray RED RIVER VALLEY RAD & (b) (6) RED RIVER VALLEY RAD & PATHOLGY (PARIS) PATHOLGY (PARIS) Paris TX X-ray REDA RASCO PSY D (WICHITA FALLS, TX) Madden Counseling Witchita Falls TX Psychology REDA RASCO PSY D (WICHITA FALLS,TX) Madden Counseling Witchita Falls TX Psychology RENETTA REEVES MD (ADA) Midwest CES Ada OK Internist RENETTA REEVES MD (MCALESTER) Midwest CES McAlester OK Internist RENETTA REEVES MD (MUSKOGEE) Midwest CES Muskogee OK Internist

RICHARD KAHOE PHD (WATONGA) RICHARD KAHOE PHD (WATONGA) Watonga OK Psychology RICHARD KAHOE PHD RICHARD KAHOE PHD (WOODWARD) (WOODWARD) Woodward OK Psychology RIVER SMITH PHD (TULSA) Advanced Pain Specialist Tulsa OK Psychology ROBERT C BALOGH MD (LAWTON) Allied Labs of Lawton Lawton OK Internist

Robert Danaher PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology ROBERT L SPRAY JR PHD PA (FT ROBERT L SPRAY JR PHD PA (FT SMITH) SMITH) Ft Smith AR Psychology ROBERT R WALLER PHD (OKC) ROBERT R WALLER PHD (OKC) OKC OK Psychology ROBIN HALL MD (OKC) Quality Medical Clinic OKC OK Internist Comprehensive Comm Rehab Russell Pella PhD Services Tulsa OK Psychology S A CHAUDHRY MD (OKC) S A CHAUDHRY MD (OKC) OKC OK Internist

S KRISHNAMURTHI MD (SAPULPA) S KRISHNAMURTHI MD (SAPULPA) Sapulpa OK Cardio SARAH CLAY OD (ARDMORE) Clay Optometry Ardmore OK Optometry SARAH MILLER COATS PHD (ENID) SARAH K Miller PhD Enid OK Psychology SEAN P SATTERFIELD MED CCC SLP SEAN P SATTERFIELD MED CCC SLP (PONCA CITY) (PONCA CITY) Ponca City OK Speech Sharon Bowen ARNP Abraham Medical Clinic Hollis OK Internist SHERMAN LAWTON MD (OKC) SHERMAN LAWTON MD (OKC) OKC OK Neurology SHERRI L MURRY PHD (OKC) Care for Change Inc OKC OK Psychology SIDNEY WILLIAMS MD (STILLWATER) Williams Clinic of Stillwater Stillwater OK Internist SOONER MEDICAL SERVICES (X- SOONER MEDICAL SERVICES (X-RAY) RAY) OKC OK X-ray

SOONER MEDICAL SERVICES(PFS) SOONER MEDICAL SERVICES(PFS) OKC OK PFS SPARKS LUNG CENTER SPARKS LUNG CENTER Ft Smith AR PFS SPENCER CLARK DO (ENID) Eve Medical Enid OK Internist SPENCER CLARK DO (WEATHERFORD) Eve Medical Weatherford OK Internist SRIKANTH REDDY MD (TULSA) Tulsa Bone and Joint Associates Tulsa Ok Internist ST ANTHONY HOSPITAL ST ANTHONY HOSPITAL OKC Ok PFS ST JOHN MED CENTER (PULM)- ST JOHN MED CENTER (PULM)-TULSA TULSA Tulsa Ok PFS ST JOHN MEDICAL CENTER ST JOHN MEDICAL CENTER (LAB)(TULSA) (LAB)(TULSA) Tulsa Ok Lab

STEPHANIE CRALL PHD (MSE) (OKC) Assessment & Consult Services PC OKC OK Psychology Stephanie Letney DO Midtown Medical Associates LLC Tulsa OK Internist STEPHEN R CLOSE PHD (ENID) STEPHEN R CLOSE PHD (ENID) Enid OK Psychology STEWART J KATZ MD (TULSA) Cardiovascular Specialist Inc Tulsa OK Cardio Sully Drotar DO Midtown Medical Associates LLC Tulsa OK Internist SUNG WOOK CHOI MD (ADA) Midwest CES Ada OK Internist SUNG WOOK CHOI MD (ARDMORE) Midwest CES Ardmore OK Internist SUNG WOOK CHOI MD (MCALESTER) Midwest CES McAlester OK Internist SUNG WOOK CHOI MD (MUSKOGEE) Midwest CES Muskogee OK Internist SUSAN M LINDE PHD (TULSA) SUSAN M LINDE PHD (TULSA) Tulsa OK Psychology SUSAN SELL SLP (WOODWARD) SUSAN SELL SLP (WOODWARD) Woodward OK Speech SUZAN B SIMMONS PHD PLLC SUZAN B SIMMONS PHD PLLC (PONCA CITY) (PONCA CITY) Ponca City OK Psychology SXR MEDICAL EVALUATIONS SXR MEDICAL EVALUATIONS (TULSA) (TULSA) Tulsa OK X-rays/labs Tatyana Mayer OD Mayer Eye Care Inc Ponca City OK Optometry TAWFIK RAMADAN MD (ADA) Southern OK Pediatrics Inc Ada OK Pediatrics Integris Cardiovascular Physicians TERRANCE KHASTGIR MD (OKC) LLC OKC OK Cardio TERRY L KILGORE MD (PARIS) TERRY L KILGORE MD (PARIS) Paris TX Internist

TEXARKANA EYE ASSOCIATES - Sean Summers OD TEXARKANA EYE ASSOCIATES Idabel OK Optometry Texoma Medical Center Texoma Medical Center Denison TX Labs THERESA HORTON PHD (IDABEL) THERESA HORTON PHD (IDABEL) (MSE) (MSE) Idabel OK Psychology

THERESA HORTON PHD (POTEAU) THERESA HORTON PHD (POTEAU) Poteau OK Psychology THERON BLISS DO (BARTLESVILLE) Eve Medical Bartlesville OK Internist THERON BLISS DO (ENID) Eve Medical Enid OK Internist THERON BLISS DO (MIAMI) Eve Medical Miami OK Internist THERON BLISS DO (WEATHERFORD) Eve Medical Weatherford OK Internist Thomas Wolf MD Urgent Eye Care Edmond OK Optometry Timothy Cramer MD Sooner Medical OKC OK Internist TIMOTHY DOTY PHD (TULSA) Christian Family Institute Tulsa OK Psychology (b) (6) TODD GRAYBILL PHD PLLC (IQ) B TODD GRAYBILL PHD PLLC (IQ) Muskogee OK Psychology

TODD GRAYBILL PHD PLLC (MSE) B TODD GRAYBILL PHD PLLC (MSE) Muskogee OK Psychology Tracie Gillispie LPC Tracie Gillispie LPC Duncan OK Psychology TREY CARLISLE OD (BEAVER) Carlisle Vision Clinic PLLC Beaver OK Optometry Tyler Freeman MD Sooner Medical Services OKC OK Internist URSULA BOWLING PSY D URSULA BOWLING PSY D (ARDMORE) (ARDMORE) Ardmore OK Psychology VICKI PERKINS PHD (BEAVER) VICKI PERKINS PHD (BEAVER) Beaver OK Psychology VICTOR T WILSON MD PC VICTOR T WILSON MD PC (NORMAN) (NORMAN) Norman OK Pediatrics VIDYA REGE MD (EL RENO) VIDYA REGE MD (EL RENO) El Reno OK Optometry VIDYA REGE MD (OKC) VIDYA REGE MD (OKC) OKC OK Optometry Virginia Burk PhD Moore Counseling Center Moore OK Psychology VISHAL KADAKIA MD (BARTLESVILLE) Eve Medical Bartlesville OK Internist VISHAL KADAKIA MD (ENID) Eve Medical Enid OK Internist VISHAL KADAKIA MD (WEATHERFORD) Eve Medical Weatherford OK Internist WILLIAM CHAPMAN MD WILLIAM CHAPMAN MD (SHAWNEE) (SHAWNEE) Shawnee OK Pediatrics William Collins MD Sooner Medical Services OKC OK Internist WILLIAM GRUBB MD (TULSA) WILLIAM GRUBB MD (TULSA) Tulsa OK Internist

WILLIAM GRUBB MD (OKMULGEE) WILLIAM GRUBB MD (OKMULGEE) Okmulgee OK Internist William K Russell MD Sooner Medical Services OKC OK Internist WILLIAM L COOPER PHD (TULSA) WILLIAM L COOPER PHD (TULSA) Tulsa OK Psychology WILLIAM T BRYANT PHD WILLIAM T BRYANT PHD (OKMULGEE) (OKMULGEE) Okmulgee OK Psychology WOJCIECH DULOWSKI MD WOJCIECH DULOWSKI MD (STILWELL) (STILWELL) Stilwell OK Internist

YEE SE CHOA ONG MD (MUSKOGEE) Cardiology Clinic of Muskogee Inc Muskogee OK Cardio Oklahoma break taxid count paidamttotal 3428 $397,378.84 Quality Medical Clinic (b) (6) 5277 $374,957.90 Sooner Medical Services 2759 $293,775.00 Alden Clinical Evaluation SVCS 1653 $202,930.00 ELN Enterprises Midwest CES 1515 $193,010.76 Midtown Medical Associates LLC 2746 $171,240.25 SXR MEDICAL LLC 1349 $144,015.00 ADVANCING PSYCHOLOGY INC R Keith Green PhD 1039 $142,200.00 CHRISTOPHER CAMPBELL PHD Oklahoma Providers who work for the DDS only Midwest CES ALDEN CLINICAL EVALUATION SVCS Eve Medical Services Sooner Medical Services Midtown Medical H&H Exams LLC Janza LLC Quality Medical Clinic DENISE LAGRAND PSY D (TAHLEQUAH) Johnnie Brasuell APRN R KEITH GREEN PHD (OKC) Advancing Psychology SHERMAN LAWTON MD (OKC) SXR Medical LLC Christopher Campbell PhD Vendor ID letter Providers name Clinic name City state Specialty

ABDOLKARIM KHORASANCHIAN MD ABDOLKARIM KHORASANCHIAN MD McAlester OK Cardio (b) (6) Abhilash Davlapur MD Sooner Medical Services OKC OK Internist ABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK Speech ABLETALK THERAPIES - Croley ABLETALK THERAPIES INC Tulsa OK Speech ADEL MALATI MD ADEL MALATI MD Okmulgee OK Internist ADEL MALATI MD ADEL MALATI MD Okemah OK Internist Akram Abraham MD Abraham Medical Clinic Hollis OK Internist Alan Miner DO Midwest CES Ada OK Internist Alan Miner DO Midwest CES Ardmore OK Internist Alan Miner DO Midwest CES McAlester OK Internist Alan Miner DO Midwest CES Muskogee OK Internist ALDEN CLINICAL EVALUATION SVCS ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology Alison Hansen-Pitts OD The Eye Institute Inc Tulsa OK Optometry Allison Craig SLP Discovery Pediatric Therapy Poteau OK Speech Alyssa Rippy PhD Advanced Pain Specialist Tulsa OK Psychology Amy Ashcraft ARNP Abraham Medical Clinic Hollis OK Internist Andrea Jones MD Sooner Medical Services OKC OK Internist Andrea Miller MD Eve Medical Services Enid OK Internist Andrea Miller MD Eve Medical Services Weatherford OK Internist Andrea Miller MD Eve Medical Services Bartlesville OK Internist Andrea Miller MD Eve Medical Services Miami OK Internist Andrew White MD Sooner Medical Services OKC OK Internist Aneri Gupta-Lim Sooner Medical Services OKC OK Internist ANIL PATEL MD Dean McGee Eye Institute OKC OK Optometry Anna M Homen PhD Moore Counseling Center Moore OK Psychology Anna M Homen PhD Moore Counseling Center Moore OK Psychology Arjun Ghodasara MD Midtown Medical Associates LLC Tulsa OK Internist Arkansas Occupational Health Arkansas Occupational Health Clinic Springdale AR Lab/Xray/PFS Arkansas Occupational Health Arkansas Occupational Health Clinic Van Buren AR Lab/Xray/PFS ASHOK KACHE MD ASHOK KACHE MD Tulsa OK EMG ASHOK KACHE MD ASHOK KACHE MD Tulsa OK Internist AUDIOLOGY OF TULSA - Lang, Nitzel, Russ, Worth, Alred AUDIOLOGY OF TULSA Tulsa OK Audiology BAILEY RUNKLES DO Midtown Medical Associates LLC Tulsa OK Internist BALA KRISHNA V ARABOLU MD BALA KRISHNA V ARABOLU MD Durant OK Pediatrics BENJAMIN ROBERTS DO Midtown Medical Associates LLC Tulsa OK Internist BETTY J FEIR PHD PC BETTY J FEIR PHD PC Texarkana TX Psychology Beverly Cooper ARNP Abraham Medical Clinic Hollis OK Internist Blake Carlisle OD Blake Carlisle OD Fairview OK Optometry BRAD LISTON DO Liston LLC Ponca City OK Internist (b) (6) BRADLEY K FARRIS MD - Neuro Opthamologist Dean McGee Eye Institute OKC OK Optometry Brandi Duncan SLP Discovery Pediatric Therapy Poteau Ok SLP BRANDI WOFFORD SLP Wofford Speech Therapy Tulsa OK Speech BRIAN BIRDWELL MD (LAWTON) BRIAN BIRDWELL MD (LAWTON) Lawton OK Internist Brian Snider PhD Psychological Services of Tulsa Tulsa OK Psychology Bronwyn Howard ARNP Main Street Family Clinic Stroud OK Internist Bryan Peck MD Eve Medical Enid OK Internist Bryan Peck MD Eve Medical Weatherford OK Internist

Mariana Navas Bryant SLP BILINGUAL COMMUNICATION POTENTIAL OKC OK Speech Cameron Smith DO H&H Exams LLC Tulsa OK Internist Catherine Fusilier MD Sooner Medical Services OKC OK Internist CE Provider Services CE Provider Services Amarillo TX Internist Charles B Fullenwider MD Midwest CES Ada OK Internist Charles B Fullenwider MD Midwest CES Ardmore OK Internist Charles B Fullenwider MD Midwest CES McAlester OK Internist Charles B Fullenwider MD Midwest CES Muskogee OK Internist CHARLES D TAYLOR MD (OKC) CHARLES D TAYLOR MD (OKC) OKC OK Internist

Charles R Vest MD Central Oklahoma Family Medical Center Ada OK Internist Chelsea Berges DO Janza LLC Tulsa OK Internist Christine Beeson DO Janza LLC Tulsa OK Internist

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Lawton OK Psychology

CHRISTOPHER CAMPBELL PHD (LAWTON) CHRISTOPHER CAMPBELL PHD (LAWTON) Pauls Valley OK Psychology Christopher Thompson DO H & H Exams Tulsa OK Internist CHRISTOPHER L SUDDUTH MD (ADA) Midwest CES Ada OK Internist Christopher L Sudduth MD (Ardmore) Midwest CES Ardmore OK Internist

CHRISTOPHER L SUDDUTH MD (MCALESTER) Midwest CES McAlester OK Internist

CHRISTOPHER L SUDDUTH MD (MUSKOGEE) Midwest CES Muskogee OK Internist CINDY L ROBERTS MS CCCA (ENID) CINDY L ROBERTS MS CCCA (ENID) Enid OK Audiology Corey Babb DO Midtown Medical Associates LLC Tulsa OK Internist Corey Matthews DO H & H Exams Tulsa OK Internist CRYSTEN CHEATWOOD DO (TULSA) Midtown Medical Associates LLC Tulsa OK Internist DANA FOLEY PHD (ARDMORE) DANA FOLEY PHD (ARDMORE) Ardmore OK Psychology DANA GUDGEL MA CCC SLP (TULSA) DANA GUDGEL MA CCC SLP (TULSA) Tulsa OK Psychology (b) (6) DARIO M ESPINA MD (FT SMITH) Arkansas Heart Center Ft Smith AR Cardio DARRELL L LYNCH PHD (LAWTON) DARRELL L LYNCH PHD (LAWTON) Lawton OK Psychology Dave Kerby PhD Moore Counseling Center Moore OK Psychology David Bishop MD Sooner Medical Services OKC OK Internist DAVID BRINKER MD (OKC) Northwest Eye Physicians OKC OK Optometry DAVID J KING DO (OKC) Quality Medical Clinic OKC OK Internist DAVID WIEGMAN MD (BARTLESVILLE) Eve Medical Bartlesville OK Internist DAVID WIEGMAN MD (MIAMI) Eve Medical Miami OK Internist

DEANN M GATTIS PHD (NORMAN) DEANN M GATTIS Psychological Services Norman OK Psychology DEANNA SEVERSON CCC SLP DEANNA SEVERSON CCC SLP Bartlesville OK Speech

DENISE LAGRAND PSY D (TAHLEQUAH) DENISE LAGRAND PSY D (TAHLEQUAH) Tahlequah OK Psychology Dennis Morris OD Vision Source Sapulpa OK Optometry Dennis Whitehouse DO Pauls Valley Medical Center Pauls Valley OK Internist DERRISE L GARNER PSY D (MIAMI) Herndon Snider & Associates PC Miami OK Psychology Divya Byragani MD Midtown Medical Associates LLC Tulsa OK Internist DLO (ADA) - Sooner Medical Diagnostic Laboratory of Oklahoma Ada OK Lab DLO (ARDMORE) - Sooner Medical Diagnostic Laboratory of Oklahoma Ardmore OK Lab DLO (CLINTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Clinton OK Lab DLO (DURANT) - Sooner Medical Diagnostic Laboratory of Oklahoma Durant OK Lab DLO (EDMOND) - Sooner Medical Diagnostic Laboratory of Oklahoma Edmond OK Lab DLO (ELK CITY) - Sooner Medical Diagnostic Laboratory of Oklahoma Elk City OK Lab DLO (ENID) - Sooner Medical Diagnostic Laboratory of Oklahoma Enid OK Lab DLO (GROVE) - Sooner Medical Diagnostic Laboratory of Oklahoma Grove OK Lab DLO (Idabel) - Sooner Medical Diagnostic Laboratory of Oklahoma Idabel OK Lab DLO (LAWTON) - Sooner Medical Diagnostic Laboratory of Oklahoma Lawton OK Lab DLO (MCALESTER) - Sooner Medical Diagnostic Laboratory of Oklahoma McAlester OK Lab DLO (MIAMI) - Sooner Medical Diagnostic Laboratory of Oklahoma Miami OK Lab DLO (MUSKOGEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Muskogee OK Lab DLO (OKC) - Sooner Medical Diagnostic Laboratory of Oklahoma OKC OK Lab DLO (SHAWNEE) - Sooner Medical Diagnostic Laboratory of Oklahoma Shawnee OK Lab DLO (STILLWATER) - Sooner Medical Diagnostic Laboratory of Oklahoma Stillwater OK Lab DLO (TULSA) - Sooner Medical Diagnostic Laboratory of Oklahoma Tulsa OK Lab Dragos Vesbianu MD Midtown Medical Associates LLC Tulsa OK Internist DUSTIN GANT WARD PHD (MOORE) Moore Counseling Center Moore OK Psychology DUSTIN GANT WARD PHD (MOORE)(IQ) Moore Counseling Center Moore OK Psychology E L JORDAN JR DO PC (JOPLIN) E L JORDAN JR DO PC (JOPLIN) Joplin MO Optometry Eddie Scott PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology Emily Sullivan SLP Moore Counseling Center Moore OK Speech ERIN RAMSEY SLP Ramsey Speech Pathology PLLC Muskogee OK Speech (b) (6) EVE MEDICAL SERVICES (ENID) EVE MEDICAL SERVICES (ENID) Enid OK PFS EVE MEDICAL SERVICES (MIAMI) EVE MEDICAL SERVICES (MIAMI) Miami OK PFS

EVE MEDICAL SERVICES (WEATHERFORD) EVE MEDICAL SERVICES (WEATHERFORD) Weatherford OK PFS Family Vision Clinic (Robert Head, Kyle Head, Kristina Flint) FAMILY VISION CLINIC (LAWTON) Lawton OK Optometry GAIL POYNER PHD (CHOCTAW)(IQ) GAIL POYNER PHD (CHOCTAW)(IQ) Choctaw OK Psychology GAIL POYNER PHD (CHOCTAW)(MSE) GAIL POYNER PHD (CHOCTAW)(MSE) Choctaw OK Psychology GARY DENSLOW MD (Muskogee) Pediatric Opthalmology Inc Muskogee OK Optometry GARY DENSLOW MD (TULSA) Pediatric Opthalmology Inc Tulsa OK Optometry GEORGE S CHRYSANT MD (ALTUS) Integris Cardiovascular Physicians LLC Altus OK Cardio GEORGE S CHRYSANT MD (CHICKASHA) Integris Cardiovascular Physicians LLC Chickasha OK Cardio GEORGE S CHRYSANT MD (ADA) Integris Cardiovascular Physicians LLC Ada OK Cardio GEORGE S CHRYSANT MD (CLINTON) Integris Cardiovascular Physicians LLC Clinton OK Cardio GEORGE S CHRYSANT MD (OKC) Integris Cardiovascular Physicians LLC OKC OK Cardio GREAT PLAINS REG MEDICAL CENTER-ELK GREAT PLAINS REG MEDICAL CENTER-ELK CITY CITY Elk City OK Lab Guila Hall MD Sooner Medical Services OKC OK Internist GWEN FUENTES MD (ARDMORE) GWEN FUENTES MD (ARDMORE) Ardmore OK Internist HAROLD ZANE DELAUGHTER DO (TULSA) Janza LLC Tulsa OK Internist Healthcare Stat (Corbert Bercier) Healthcare Stat Chickasha OK Internist Healthcare Stat (Dustin Wade) Healthcare Stat Chickasha OK Internist Healthcare Stat (Heather Worden) Healthcare Stat Chickasha OK Internist Healthcare Stat (Lindsey Leehan) Healthcare Stat Chickasha OK Internist Healthcare Stat (Martin Christensen) Healthcare Stat Chickasha OK Internist Healthcare Stat (Shawn Bonilla) Healthcare Stat Chickasha OK Internist Healthcare Stat (Tonya Jones) Healthcare Stat Chickasha OK Internist

HEARTS FOR HEARING - (Wolfe, Neumann) HEARTS FOR HEARING OKC OK Audiology HEATHER RANGER PHD (TULSA) HEATHER RANGER PHD (TULSA) Tulsa OK Psychology Hope Burkett DO H&H Exams LLC Tulsa OK Internist Ilse Carrizales PhD Moore Counseling Center Moore OK Psychology INNOVATIVE EXPRESSIONS INNOVATIVE EXPRESSIONS Edmond Ok Speech

JACOB AZURDIA MD (Sooner Medical OKC) Sooner Medical Services OKC OK Internist JACOB AZURDIA MD(ENID) Eve Medical Enid OK Internist JACOB AZURDIA MD(WEATHERFORD) Eve Medical Weatherford OK Internist JAMES CHAPMAN MD (GROVE) Oklahoma Heart Institute Grove Ok Cardio JAMES CRUTCHER MD (BARTLESVILLE) Eve Medical Bartlesville Ok Internist JAMES CRUTCHER MD (MIAMI) Eve Medical Miami Ok Internist JAMES H GENTRY DO (ADA) Midwest CES Ada Ok Internist (b) (6) JAMES H GENTRY DO (ARDMORE) Midwest CES Ardmore Ok Internist JAMES H GENTRY DO (MCALESTER) Midwest CES McAlester Ok Internist JAMES H GENTRY DO (MUSKOGEE) Midwest CES Muskogee OK Internist JAMES L BURKE DO (OKC) Quality Medical Clinic OKC OK Internist JAMES SCOTT PSY D (SHAWNEE) (MSE) Ok Assessment & Therapy Services Shawnee OK Psychology JAMES SCOTT PSY D (SHAWNEE)(IQ) Ok Assessment & Therapy Services Shawnee OK Psychology JAN S KENT PHD (MIAMI) Herndon Snider & Associates PC Joplin MO Psychology JANA B KLUCK MA CCC SLP (OKC) JANA B KLUCK MA CCC SLP (OKC) OKC OK Speech JANET KATES PHD (OKC) JANET KATES PHD (OKC) OKC OK Psychology Jason Pickard OD Cornerstone Eye Care OKC OK Optometry Jennifer Davis SLP Ramsey Speech Pathology PLLC Muskogee OK Speech

JENNIFER LANCASTER PHD (NORMAN)(IQ) Lancaster Psychological Services Norman OK Psychology

JENNIFER LANCASTER PHD (NORMAN)(MSE) Lancaster Psychological Services Norman OK Psychology JENNY BENDURE PhD Serinity Mental Health Norman OK Psychology JEROME M DILLING JR MD (ENID) JEROME M DILLING JR MD (ENID) Enid OK Audiology JERRY CHILDS JR DO (OKC) Quality Medical Clinic OKC OK Internist JERRY D FIRST MD (TULSA) JERRY D FIRST MD (TULSA) Tulsa OK Internist JERRY D WHITE PHD (OKC) JERRY D WHITE PHD (OKC) OKC OK Psychology JOHN B BARRINGER OD (ARDMORE) Vision Source Ardmore OK Optometry JOHN FARAG DO (Eve Medical) Eve Medical Weatherford OK Internist JOHN FARAG DO (Sooner Medical) Sooner Medical OKC OK Internist JOHN J ALPAR MD (AMARILLO) JOHN J ALPAR MD (AMARILLO) Amarillo TX Optometry JOHN RICE DO (CHECOTAH) Payne & Rice Clinic Checotah OK Internist JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK Psychology JOHNA KAY SMASAL PHD (TULSA) JOHNA KAY SMASAL PHD (TULSA) Tulsa OK Psychology Johnnie Brasuell APRN Johnnie Brasuell APRN Catoosa OK Internist JOHNSON GOURD MD (MIAMI) Eve Medical Miami OK Internist JOSE A ALEMPARTE MD (FT SMITH) JOSE A ALEMPARTE MD (FT SMITH) Ft Smith AR Cardio JOSEPH JAMES PSY D (TULSA) (TEST) Christian Family Institute Tulsa OK Psychology JOSEPH JAMES PSY D (TULSA)(MSE) Christian Family Institute Tulsa OK Psychology JUAN MALDONADO MD (ANADARKO) JUAN MALDONADO MD (ANADARKO) Anadarko OK Internist JUAN RANGO MD (ADA) Midwest CES Ada OK Internist JUAN RANGO MD (ARDMORE) Midwest CES Ardmore OK Internist JUAN RANGO MD (MCALESTER) Midwest CES McAlester OK Internist JUAN RANGO MD (MUSKOGEE) Midwest CES Muskogee OK Internist JUSTIN ANDERSON MD (OKC) Quality Medical Clinic OKC Ok Internist Justin Funk OD Premier Eyecare of Enid Enid OK Optometry KARA RODGERS PSY D (OKC) Brookwood Psychological Services OKC Ok Psychology (b) (6) KATHLEEN A WARD PHD (MCALESTER) KATHLEEN A WARD PHD (MCALESTER) McAlester Ok Psychology KEITH GREEN PHD (OKC) R KEITH GREEN PHD (OKC) OKC Ok Psychology KENNY A PARIS PHD (TAHLEQUAH) KENNY A PARIS PHD (TAHLEQUAH) Tahlequah Ok Psychology Kent Abernathy DO Midtown Medical Associates LLC Tulsa OK Internist KEVIN M WHISMAN PSY D (JOPLIN) KEVIN M WHISMAN PSY D (JOPLIN) Joplin MO Psychology Kimi Carson PhD Moore Counseling Center Moore OK Psychology Konstantin Berestnev MD Arkansas Occupational Health Clinic Springdale AR Internist Konstantin Berestnev MD Arkansas Occupational Health Clinic Van Buren AR Internist KRISTI L BRATKOVICH PHD (LAWTON) KRISTI L BRATKOVICH PHD (LAWTON) Lawton OK Psychology Lacy Crissup OD Claremore Eye Associates Claremore OK Optometry LARRY VAUGHT PHD (TULSA) LARRY VAUGHT PHD (TULSA) Tulsa OK Psychology Leah Upton DO Jenks Health Team Jenks Ok Internist Leomar Bautista DO H & H Exams Tulsa OK Internist Lesley Flores SLP Lesley Flores SLP Tulsa OK Speech Levi Armstrong PhD Paris Counseling Center Paris TX Psychology

LINDA K CAMERON MA CCC (EDMOND) LINDA K CAMERON MA CCC (EDMOND) Edmond OK Speech M. Said Sadeghi DO Pediatric Opthalmology Inc Tulsa OK Optometry

MARK ENGLANDER PHD (MSE) (NORMAN) MARK ENGLANDER PHD (MSE) (NORMAN) Norman OK Psychology

MARK ENGLANDER PHD (MSE) (NORMAN) MARK ENGLANDER PHD (MSE) (NORMAN) Norman OK Psychology MARK WOOD MD (OKC) Otologic Medical Clinic OKC OK Audiology MARTIN D BAUTISTA MD (GUYMON) Specialty Clinics Of St Anne PLLC Guymon OK Internist MARY MARGUERITE LANGILLE-HOPPE PSY D (SHAWNEE) Ok Assessment & Therapy Services Shawnee OK Psychology Matthew Heisey APRN Pauls Valley Medical Center Pauls Valley OK Internist MATTHEW PHILIP FEIST MD (ADA) Midwest CES Ada OK Internist MATTHEW PHILIP FEIST MD (ARDMORE) Midwest CES Ardmore OK Internist

MATTHEW PHILIP FEIST MD (MCALESTER) Midwest CES McAlester OK Internist Matthew Philip Feist MD (Muskogee) Midwest CES Muskogee OK Internist Matthew Smith DO H & H Exams Tulsa OK Internist MAX CARLISLE OD (FAIRVIEW) MAX CARLISLE OD (FAIRVIEW) Fairview OK Optometry Maxwell Sencherey DO H & H Exams Tulsa OK Internist

MCCURTAIN MEMORIAL HOSPITAL-PFS MCCURTAIN MEMORIAL HOSPITAL-PFS Idabel OK PFS MELINDA SHAVER PSY D (BARTLESVILLE) MELINDA SHAVER PSY D (BARTLESVILLE) (MSE) (MSE) Bartlesville OK Psychology MICHAEL KARATHANOS MD (TULSA) MICHAEL KARATHANOS MD (TULSA) Tulsa OK Neurology (b) (6) MICHAEL MCGEE MD (OKC) Otologic Medical Clinic OKC OK Audiology MICHAEL SCHIFF MD (PONCA CITY) Integris Cardiovascular Physicians LLC Ponca City OK Cardio

MICHELINE CHRISMAN PSYD (NORMAN) MICHELINE CHRISMAN PSYD (NORMAN) Norman OK Psychology MINOR GORDON PHD (CLAREMORE) MINOR GORDON PHD (CLAREMORE) Claremore OK Psychology MIRACLE GOETZ PSY D (MOORE)(IQ) Moore Counseling Center Moore OK Psychology MIRACLE GOETZ PSY D (MOORE)(MSE) Moore Counseling Center Moore OK Psychology NANCY FAYE BARTON PHD (TULSA) NANCY FAYE BARTON PHD (TULSA) Tulsa OK Psychology NICK LEE CARROLL DO (TULSA) Midtown Medical Associates LLC Tulsa OK Internist OKEY NWOKOLO MD (OKC) Okey Nwololo MD & Associates OKC OK Pediatrics PAUL J SCHWARTZ PHD (TULSA) PAUL J SCHWARTZ PHD (TULSA) Tulsa OK Psychology

PAUL J SCHWARTZ PHD (TULSA) (TEST) PAUL J SCHWARTZ PHD (TULSA) (TEST) Tulsa OK Psychology PAUL S THOMAS MD (MCALESTER) Warren Clinic McAlester OK Psychology Pauls Valley Medical Center Pauls Valley Medical Center Pauls Valley OK X-rays/labs Peggy Gardner ARNP Main Street Family Clinic Stroud OK Internist PETER CIALI PHD (TULSA) Advanced Pain Specialist Tulsa OK Psychology Peter Holm PhD Peter Holm PhD Sherman TX Psychology PULMONARY PHYSICIANS OF OKC PULMONARY PHYSICIANS OF OKC OKC OK PFS QTC MEDICAL GROUP INC (LAWTON) QTC MEDICAL GROUP INC (LAWTON) Lawton Ok X-ray/labs QTC MEDICAL GROUP INC (OKC) QTC MEDICAL GROUP INC (OKC) OKC Ok X-ray/labs

QUALITY MEDICAL CLINIC (OKC)-PFS/LAB QUALITY MEDICAL CLINIC (OKC)-PFS/LAB OKC Ok PFS/Labs RACHEL SMILEY PHD (IQ) (MOORE) Moore Counseling Center Moore Ok Psychology RACHEL SMILEY PHD (MOORE)(MSE) Moore Counseling Center Moore Ok Psychology RAFAEL F OTERO PHD (TEXARKANA) RAFAEL F OTERO PHD (TEXARKANA) Texarkana TX Psychology RAY HAND PHD (OKC) RAY HAND PHD (OKC) OKC OK Psychology Raymond Azadgoli MD Quality Medical Clinic OKC Ok Internist RED RIVER VALLEY RAD & PATHOLGY RED RIVER VALLEY RAD & PATHOLGY (PARIS) (PARIS) Paris TX X-ray RED RIVER VALLEY RAD & PATHOLGY RED RIVER VALLEY RAD & PATHOLGY (PARIS) (PARIS) Paris TX X-ray REDA RASCO PSY D (WICHITA FALLS, TX) Madden Counseling Witchita Falls TX Psychology REDA RASCO PSY D (WICHITA FALLS,TX) Madden Counseling Witchita Falls TX Psychology RENETTA REEVES MD (ADA) Midwest CES Ada OK Internist RENETTA REEVES MD (MCALESTER) Midwest CES McAlester OK Internist RENETTA REEVES MD (MUSKOGEE) Midwest CES Muskogee OK Internist RICHARD KAHOE PHD (WATONGA) RICHARD KAHOE PHD (WATONGA) Watonga OK Psychology RICHARD KAHOE PHD (WOODWARD) RICHARD KAHOE PHD (WOODWARD) Woodward OK Psychology RIVER SMITH PHD (TULSA) Advanced Pain Specialist Tulsa OK Psychology ROBERT C BALOGH MD (LAWTON) Allied Labs of Lawton Lawton OK Internist (b) (6) Robert Danaher PhD ALDEN CLINICAL EVALUATION SVCS El Reno OK Psychology ROBERT L SPRAY JR PHD PA (FT SMITH) ROBERT L SPRAY JR PHD PA (FT SMITH) Ft Smith AR Psychology ROBERT R WALLER PHD (OKC) ROBERT R WALLER PHD (OKC) OKC OK Psychology ROBIN HALL MD (OKC) Quality Medical Clinic OKC OK Internist Russell Pella PhD Comprehensive Comm Rehab Services Tulsa OK Psychology S A CHAUDHRY MD (OKC) S A CHAUDHRY MD (OKC) OKC OK Internist S KRISHNAMURTHI MD (SAPULPA) S KRISHNAMURTHI MD (SAPULPA) Sapulpa OK Cardio SARAH CLAY OD (ARDMORE) Clay Optometry Ardmore OK Optometry SARAH MILLER COATS PHD (ENID) SARAH K Miller PhD Enid OK Psychology SEAN P SATTERFIELD MED CCC SLP (PONCA SEAN P SATTERFIELD MED CCC SLP (PONCA CITY) CITY) Ponca City OK Speech Sharon Bowen ARNP Abraham Medical Clinic Hollis OK Internist SHERMAN LAWTON MD (OKC) SHERMAN LAWTON MD (OKC) OKC OK Neurology SHERRI L MURRY PHD (OKC) Care for Change Inc OKC OK Psychology SIDNEY WILLIAMS MD (STILLWATER) Williams Clinic of Stillwater Stillwater OK Internist SOONER MEDICAL SERVICES (X-RAY) SOONER MEDICAL SERVICES (X-RAY) OKC OK X-ray SOONER MEDICAL SERVICES(PFS) SOONER MEDICAL SERVICES(PFS) OKC OK PFS SPARKS LUNG CENTER SPARKS LUNG CENTER Ft Smith AR PFS SPENCER CLARK DO (ENID) Eve Medical Enid OK Internist SPENCER CLARK DO (WEATHERFORD) Eve Medical Weatherford OK Internist SRIKANTH REDDY MD (TULSA) Tulsa Bone and Joint Associates Tulsa Ok Internist ST ANTHONY HOSPITAL ST ANTHONY HOSPITAL OKC Ok PFS ST JOHN MED CENTER (PULM)-TULSA ST JOHN MED CENTER (PULM)-TULSA Tulsa Ok PFS

ST JOHN MEDICAL CENTER (LAB)(TULSA) ST JOHN MEDICAL CENTER (LAB)(TULSA) Tulsa Ok Lab STEPHANIE CRALL PHD (MSE) (OKC) Assessment & Consult Services PC OKC OK Psychology Stephanie Letney DO Midtown Medical Associates LLC Tulsa OK Internist STEPHEN R CLOSE PHD (ENID) STEPHEN R CLOSE PHD (ENID) Enid OK Psychology STEWART J KATZ MD (TULSA) Cardiovascular Specialist Inc Tulsa OK Cardio Sully Drotar DO Midtown Medical Associates LLC Tulsa OK Internist SUNG WOOK CHOI MD (ADA) Midwest CES Ada OK Internist SUNG WOOK CHOI MD (ARDMORE) Midwest CES Ardmore OK Internist SUNG WOOK CHOI MD (MCALESTER) Midwest CES McAlester OK Internist SUNG WOOK CHOI MD (MUSKOGEE) Midwest CES Muskogee OK Internist SUSAN M LINDE PHD (TULSA) SUSAN M LINDE PHD (TULSA) Tulsa OK Psychology SUSAN SELL SLP (WOODWARD) SUSAN SELL SLP (WOODWARD) Woodward OK Speech SUZAN B SIMMONS PHD PLLC (PONCA SUZAN B SIMMONS PHD PLLC (PONCA CITY) CITY) Ponca City OK Psychology SXR MEDICAL EVALUATIONS (TULSA) SXR MEDICAL EVALUATIONS (TULSA) Tulsa OK X-rays/labs Tatyana Mayer OD Mayer Eye Care Inc Ponca City OK Optometry (b) (6) TAWFIK RAMADAN MD (ADA) Southern OK Pediatrics Inc Ada OK Pediatrics TERRANCE KHASTGIR MD (OKC) Integris Cardiovascular Physicians LLC OKC OK Cardio TERRY L KILGORE MD (PARIS) TERRY L KILGORE MD (PARIS) Paris TX Internist TEXARKANA EYE ASSOCIATES - Sean Summers OD TEXARKANA EYE ASSOCIATES Idabel OK Optometry Texoma Medical Center Texoma Medical Center Denison TX Labs

THERESA HORTON PHD (IDABEL) (MSE) THERESA HORTON PHD (IDABEL) (MSE) Idabel OK Psychology THERESA HORTON PHD (POTEAU) THERESA HORTON PHD (POTEAU) Poteau OK Psychology THERON BLISS DO (BARTLESVILLE) Eve Medical Bartlesville OK Internist THERON BLISS DO (ENID) Eve Medical Enid OK Internist THERON BLISS DO (MIAMI) Eve Medical Miami OK Internist THERON BLISS DO (WEATHERFORD) Eve Medical Weatherford OK Internist Thomas Wolf MD Urgent Eye Care Edmond OK Optometry Timothy Cramer MD Sooner Medical OKC OK Internist TIMOTHY DOTY PHD (TULSA) Christian Family Institute Tulsa OK Psychology TODD GRAYBILL PHD PLLC (IQ) B TODD GRAYBILL PHD PLLC (IQ) Muskogee OK Psychology TODD GRAYBILL PHD PLLC (MSE) B TODD GRAYBILL PHD PLLC (MSE) Muskogee OK Psychology Tracie Gillispie LPC Tracie Gillispie LPC Duncan OK Psychology TREY CARLISLE OD (BEAVER) Carlisle Vision Clinic PLLC Beaver OK Optometry Tyler Freeman MD Sooner Medical Services OKC OK Internist URSULA BOWLING PSY D (ARDMORE) URSULA BOWLING PSY D (ARDMORE) Ardmore OK Psychology VICKI PERKINS PHD (BEAVER) VICKI PERKINS PHD (BEAVER) Beaver OK Psychology VICTOR T WILSON MD PC (NORMAN) VICTOR T WILSON MD PC (NORMAN) Norman OK Pediatrics VIDYA REGE MD (EL RENO) VIDYA REGE MD (EL RENO) El Reno OK Optometry VIDYA REGE MD (OKC) VIDYA REGE MD (OKC) OKC OK Optometry Virginia Burk PhD Moore Counseling Center Moore OK Psychology VISHAL KADAKIA MD (BARTLESVILLE) Eve Medical Bartlesville OK Internist VISHAL KADAKIA MD (ENID) Eve Medical Enid OK Internist VISHAL KADAKIA MD (WEATHERFORD) Eve Medical Weatherford OK Internist WILLIAM CHAPMAN MD (SHAWNEE) WILLIAM CHAPMAN MD (SHAWNEE) Shawnee OK Pediatrics William Collins MD Sooner Medical Services OKC OK Internist WILLIAM GRUBB MD (TULSA) WILLIAM GRUBB MD (TULSA) Tulsa OK Internist WILLIAM GRUBB MD (OKMULGEE) WILLIAM GRUBB MD (OKMULGEE) Okmulgee OK Internist William K Russell MD Sooner Medical Services OKC OK Internist WILLIAM L COOPER PHD (TULSA) WILLIAM L COOPER PHD (TULSA) Tulsa OK Psychology WILLIAM T BRYANT PHD (OKMULGEE) WILLIAM T BRYANT PHD (OKMULGEE) Okmulgee OK Psychology WOJCIECH DULOWSKI MD (STILWELL) WOJCIECH DULOWSKI MD (STILWELL) Stilwell OK Internist YEE SE CHOA ONG MD (MUSKOGEE) Cardiology Clinic of Muskogee Inc Muskogee OK Cardio Onsite Reviews VISHAL KADAKIA MD (ENID) VISHAL KADAKIA MD (WEATHERFORD) VIDYA REGE MD (EL RENO) Moore Counseling (Moore Okla) SPENCER CLARK DO (ENID) TERRANCE KHASTGIR MD (OKC) THERON BLISS DO (WEATHERFORD) SARAH MILLER COATS PHD (ENID) Robert Danaher PhD PULMONARY PHYSICIANS OF OKC KEITH GREEN PHD (OKC) JOHN FARAG DO (Eve Medical) JANA B KLUCK MA CCC SLP (OKC) JACOB AZURDIA MD(WEATHERFORD) Healthcare Stat (Corbert Bercier) Healthcare Stat (Dustin Wade) Healthcare Stat (Heather Worden) Healthcare Stat (Lindsey Leehan) Healthcare Stat (Martin Christensen) Healthcare Stat (Shawn Bonilla) Healthcare Stat (Tonya Jones) Midtown Medical Associates (Tulsa OK) Eddie Scott PhD Beverly Cooper ARNP Amy Ashcraft ARNP Akram Abraham MD Midtown Medical Associates Tulsa Oklahoma Audiology of Tulsa Brad Liston DO Ponca City Dennis Morris OD Sapulpa Oklahoma Johnnie Brausell ARNP Catoosa Oklahoma Christian Family Institute Tulsa Ok Claremore Eye Associates Claremore Oklahoma H&H Exams Tulsa Oklahoma Pediatric Ophthalmology Tulsa OK Minor Gordon PhD Claremore Ok Sean Satterfield SLP Ponca City SXR Evaluations Tulsa Ok Mayer Eye Care Ponca City Robin Hall MD OKC Quality Medical Clinic OKC Mark Englander PhD Norman Victor Wilson MD Norman Jerry Childs Jr DO David King DO OKC Ramond Azadgoli MD OKC James Burke DO OKC Justin Anderson MD OKC Sooner Medical Services OKC Midwest CES McAlester and Ada Table Guide CE Licensing Check for FY 2015 1 Oregon providers doing Psychological Exams (PSY) 2 Oregon providers doing Occupational Therapy and Physical Therapy Exams (OT & PT) 3 Oregon providers doing Opthomology exams (OD) 4 Washington providers doing exams for Oregon Claimants (WA) 5 Idaho providers doing exams for Oregon Claimants (Idaho) 6 California providers doing exams for Oregon Claimants (CA) 7 Oregon Hospitals doing X-Rays, Pulmonary Function Tests, Doppler's, etc. (Hospitals) 8 Oregon providers doing Audiology and Speech Language exams (AuD & SLP) 9 Oregon Medical Doctors and Doctors of Osteopathic Medicine doing physical exams (MD & DO)

Individual table column headings: 1 Column notes the providers name or clinic name. 2 Column provides the name of the clinic or group the provider is associated with. 3 Column notes the region of Oregon and city the providers office is located in. OR groups resources regionally. 4 Column notes the month/year of the last onsite office visit. Some providers have remote locations and visits are rare. 5 Column notes which is a key and non-key provider. 6 Column notes the providers license number. 7 Column notes the providers license expiration date. 8 Column notes if the provider has had any SAMS sanctions.

Updated 10/13/2017 WPL OR DDS CE Licensing Check for PSY FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration SAMS Check (Group/Clinic) Month/Year Provider Number

(b) (6) Adler, John, PhD: PDX NE Met: Gresham Jul-17 Non-Key (b) (6) 6/30/2018 None Alvord, Scott T, PsyD: (b) (6) Office space at North Roseburg Met: North Bend Sep-16 Top 5 10/31/2018 None Bend DHS Alvord, Scott T, PsyD: (b) (6) Office space at Roseburg Roseburg Met: Roseburg Sep-16 Top 5 10/31/2018 None SPD Alvord, Scott T, PsyD: (b) (6) Riverview Business Park Eugene Met: Eugene TBD New Top 5 10/31/2018 None Office Alvord, Scott T, PsyD: (b) (6) Lake Oswego Medical PDX SE Met: Lake Oswego Sep-17 Top 5 10/31/2018 None Barnes, Andrew, PhD: (b) (6) (NWOM) PDX NW Met: Beaverton Jun-16 Non-Key 7/31/2018 None Bee, Heather A, PsyD: (b) (6) Astoria Met: Astoria Sep-17 Non-Key 12/31/2018 None Belcher, Paula M, PhD: (b) (6) Eugene Met: Eugene Aug-16 Non-Key 6/30/2019 None Brischetto, Cheryl, PhD: (b) (6) PDX NW Met: Portland Jun-16 Non-Key 8/31/2019 None Broadwell, PsyD MDSI MDSI N/A N/A 12/31/2017 None Calkins, Roderick, PhD: (b) (6) Portland PSY Clinic PDX NE Met: Portland Sep-17 Non-Key 5/31/2018 None Clausel, Jeff, PhD: (b) (6) Office space @ La Grande Pendleton Met: La Grande Oct-15 Non-Key 9/30/2019 None DHS Clausel, Jeff, PhD: (b) (6) Office space @ Baker SPD Pendleton Met: Baker City Oct-15 Non-Key 9/30/2019 None Clausel, Jeff, PhD: (b) (6) Office space @ Ontario Ontario Met: Ontario TBA New Non-Key 9/30/2019 None DHS Office Cogburn, Robinann, PhD: (b) (6) PDX NW Met: Portland Booked Out Non-Key 4/30/2019 None Cole, Greg A, PhD: (b) (6) PDX NE Met: Portland Sep-17 Non-Key 8/31/2018 None Cole, Greg A, PhD: (b) (6) Salem Met: McMinnville Oct-17 Non-Key 8/31/2018 None Cole, Greg A, PhD: (b) (6) Medford Met: Klamath Falls May-15 Non-Key 8/31/2018 None Cole, Greg A, PhD: (b) (6) Roseburg SPD Office Roseburg Met: Roseburg Sep-16 Non-Key 8/31/2018 None Cole, Greg A, PhD: (b) (6) Newport OVRS Albany Met: Newport Sep-16 Non-Key 8/31/2018 None

Condon, Stephen, PhD: (b) (6) Pendleton Met: Pendleton Oct-15 Non-Key 2/28/2019 None Dehaan-Sullivan, Rita, PhD: (b) (6) Medford Met: Medford May-15 Non-Key 5/31/2018 None

Dickinson, Mercedes, PhD: (b) (6) Southern OR Klamath. Medford Met: Medford May-15 Non-Key 1/31/2019 None Updated 11/09/2017 WPL OR DDS CE Licensing Check for PSY FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration SAMS Check (Group/Clinic) Month/Year Provider Number

Dietlein, Nick R, PsyD: (b) (6) Mid Valley Counseling Salem Met: Salem (b) (6) Jul-17 Non-Key 10/31/2018 None Dillon, Mark G, PhD: (b) (6) PDX NE Met: Portland Sep-17 Non-Key 8/31/2019 None Dooley, Tom M, PsyD: (b) (6) East Side PSY PDX Obgyn PDX NE Met: Portland Oct-17 Non-Key 11/22/2018 None Doppelt, Lee H, PhD: (b) (6) PDX NW Met: Lake Oswego Oct-17 Non-Key 3/31/2018 None Dudley, Kenneth, PhD:(b) (6) Office space at DHS Bldg. Pendleton Met: La Grande Oct-15 Moved 3/17 12/31/2017 None Dudley, Kenneth, PhD: (b) (6) Pendleton Met: Baker City Oct-15 Moved 3/17 12/31/2017 None Dudley, Kenneth, PhD: (b) (6) Office space at DHS Bldg. Pendleton Met: Enterprise N/A Moved 3/17 12/31/2017 None Ethel-King, Patrick, PhD: (b) (6) New Horizons PDX NW Met: Beaverton Jun-16 Non-Key 7/31/2018 None Wellness Serv. Evans, Stephanie C, PsyD: (b) (6) Pendleton Professional Pendleton Met: Pendleton Oct-15 Non-Key 2/28/2018 None Services Ferreira, Carolyn, PsyD: (b) (6) Cascade Psychological Bend Met: Bend Oct-17 Non-Key 12/31/2017 None Gibby-Smith, Barbara, PsyD: (b) (6) PDX NW Met: Forest Grove Jun-16 Non-Key 12/31/2017 None Gomes, Manuel J, PhD MDSI MDSI N/A N/A 2/28/2019 None Goodale, Kimberly, PhD: (b) (6) (NWOM) PDX NW Met: Beaverton Jun-16 Non-Key 6/30/2018 None Gostnell, David R, PhD: (b) (6) PDX NE Met: Portland Sep-17 Key Provider 11/30/2017 None Gostnell, David, PhD: (b) (6) Nehalem Bay Health Astoria Met: Wheeler Sep-17 Key Provider 11/30/2017 None District Greene, Katherine, PsyD: (b) (6) Medford Met: Phoenix May-15 Non-Key 7/31/2018 None Greif, Elaine, PhD: (b) (6) PDX NW Met: Portland Jun-16 Non-Key 12/31/2017 None

Updated 11/09/2017 WPL OR DDS CE Licensing Check for PSY FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration SAMS Check (Group/Clinic) Month/Year Provider Number

Hallenburg, Kris, PhD MDSI MDSI N/A N/A (b) (6) 12/31/2017 None Huggins, Stephen, PhD: (b) (6) PDX NE Met: Gresham Jul-17 Non-Key 7/31/2019 None Janzen, Darren, PhD: (b) (6) CDRC Doernbecher PDX SW Met: Portland Jul-17 Non-Key 7/31/2018 None Johnston, Shawn, PhD: (b) (6) PDX NE Met: Oregon City Jun-17 Retired 6/17 5/31/2018 None Kaper, Scott, PhD: (b) (6) PDX NE Met: Clackamas Jul-17 Non-Key 2/28/2019 None Kaper, Scott, PhD: (b) (6) PDX NW Met: Tualatin Jul-17 Non-Key 2/28/2019 None Kollross, Natalie, PsyD: (b) (6) Pendleton Professional Pendleton Met: Pendleton Oct-15 Non-Key 7/31/2018 None Services Kruger, Robert, PsyD: (b) (6) Salem Met: Salem Jul-17 Non-Key 3/31/2019 None Lahman, Frank, PhD: (b) (6) Rehab Associates NW Albany Met: Corvallis Feb-16 Non-Key 11/30/2018 None Lake, Claudia, PsyD MDSI MDSI N/A Not using 4/17 5/31/2019 None

Larson, Jamie, PsyD MDSI MDSI N/A N/A 8/31/2018 None Leland, Michael, PhD: (b) (6) (NWOM) PDX NW Met: Beaverton Jun-16 Retired 6/17 11/30/2019 None McConochie, William, PhD: (b) (6) Emotional Ed. Service Eugene Met: Eugene Aug-16 Non-Key 5/31/2018 None MDSI: (b) (6) MDSI Eugene Met: Eugene Aug-16 Top 5 N/A None MDSI: (b) (6) MDSI Medford Met: Medford May-15 Top 5 N/A None MDSI: (b) (6) MDSI Salem Met: Salem Apr-17 Top 5 N/A None MDSI: (b) (6) MDSI PDX NE Met: Portland Sep-17 Top 5 N/A None MDSI: (b) (6) MDSI (PSY Only) Roseburg Met: Coos Bay Sep-16 Top 5 N/A None Michaud, Lois, PhD: (b) (6) Eugene Met: Eugene Sep-16 Non-Key 8/31/2019 None Miller, Pamela, PhD: (b) (6) PDX NE Met: The Dalles Oct-15 Non-Key 5/31/2019 None Mours, James, PhD: (b) (6) PDX NE Met: Oregon City Closed this Aug-15 5/31/2018 None office 8/17 Mours, James, PhD: (b) (6) PDX NE Met: Clackamas Jul-17 Non-Key 5/31/2018 None Updated 11/09/2017 WPL OR DDS CE Licensing Check for PSY FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration SAMS Check (Group/Clinic) Month/Year Provider Number

Mours, James, PhD: (b) (6) PDX NE Met: Milwaukie Oct-17 Non-Key (b) (6) 5/31/2018 None Northway, David, PhD: (b) (6) Eugene Met: Eugene Sep-16 Non-Key 12/31/2018 None O'Connell, Michael, PhD: (b) (6) Medford Met: Medford May-15 Non-Key 9/30/2019 None Patrick, Luke, PhD: (b) (6) Wildwood PSY Resource PDX NW Met: Beaverton Jun-16 Non-Key 1/31/2018 None Pearson, Edwin, PhD: (b) (6) Medford Met: Medford May-15 Non-Key 8/31/2019 None (b) (6) Potter, Thomas, PhD: Salem Met: Salem Jul-17 Non-Key 11/30/2018 None Powers, Peter, PhD: (b) (6) Eugene Met: Eugene Aug-16 Non-Key 7/31/2018 None Reynolds, Rosemarie, PhD: (b) (6) Medford Metro: Brookings Sep-16 Non-Key 7/31/2018 None Roman, Pamela, PhD: (b) (6) Eugene Met: Eugene Sep-16 Non-Key 6/30/2019 None Sacks, Gary, PhD: (b) (6) PDX NW Met: Portland Jun-16 Non-Key 5/31/2018 None Scharf, Daniel, PhD: (b) (6) PDX NW Met: Beaverton Sep-17 Non-Key 2/28/2018 None Sher, Jeffrey, PhD: (b) (6) PDX SW Met: Portland Sep-17 Non-Key 12/31/2017 None Shields, Thomas, PhD: (b) (6) Medford Metro: Ashland May-15 Non-Key 10/31/2018 None Shields, Thomas, PhD: (b) (6) Medford Met: Grants Pass May-15 Non-Key 10/31/2018 None Smith, Lynette, PsyD MDSI MDSI N/A N/A 7/31/2019 None Smith, Regan, PhD: (b) (6) CDRC Eugene Met: Eugene Sep-16 Non-Key 11/30/2017 None Smyth, Douglas, PhD: (b) (6) Albany Met: Corvallis Feb-16 Non-Key 8/31/2018 None Starbird, Jane, PhD: (b) (6) Nehalem Bay Health Astoria Met: Wheeler Sep-17 Key Provider 1/31/2018 None District Stoltzfus, Pau, PsyD: (b) (6) Behavioral Health Clinic Salem Met: Newberg Oct-17 Non-Key 4/30/2019 None Stoltzfus, Paul, PsyD: (b) (6) Mid Valley Counseling Salem Met: Salem Apr-17 Non-Key 4/30/2019 None Stradinger, Kay, PsyD: MDSI MDSI N/A Moved 8/17 9/30/2017 None Stuckey, Marc, PsyD: (b) (6) PDX NW Met: Hillsboro Jun-16 Non-Key 4/30/2018 None Stuckey, Marc, PsyD: (b) (6) Astoria Met: Astoria Sep-17 Non-Key 4/30/2018 None Templeman, Terrell, PhD: (b) (6) Pendleton Professional Pendleton Met: Pendleton Oct-15 Non-Key 12/31/2018 None Services Tongue, Chris, PhD: (b) (6) PDX NE Met: Gresham Jul-17 Non-Key 5/31/2018 None Torres, Robert, PhD: (b) (6) PDX NE Met: Milwaukie Oct-17 Non-Key 2/28/2019 None Trueblood, William, PhD: (b) (6) Bend Met: Bend Oct-17 Non-Key 2/28/2019 None Tucker, Brian, PsyD: (b) (6) PDX NE Met: Portland Sep-17 Non-Key 7/31/2018 None

Updated 11/09/2017 WPL OR DDS CE Licensing Check for PSY FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration SAMS Check (Group/Clinic) Month/Year Provider Number

Veith, Dale, PsyD: (b) (6) PSY Asses. Services and Salem Met: McMinnville Jul-17 Ceased 10/17 11/20/2017 None TX (b) (6) Villanueva, Michael, PsyD: (b) (6) Southern OR Klamath . Medford Met: Medford May-15 Non-Key 7/31/2019 None Fam. Practice. Villanueva, Michael, PsyD: (b) (6) Roseburg Neuro Roseburg Met: Roseburg Sep-16 Non-Key 7/31/2019 None Villanueva, Michael, PsyD: (b) (6) Klamath Family Practice Medford Met: Klamath Falls May-15 Non-Key 7/31/2019 None Wahl, Gail L, PhD: (b) (6) Hall Building Roseburg Met: Coos Bay Sep-16 Non-Key 6/30/2019 None Wang, Martha, PhD: (b) (6) Adagio Therapy CTR LLC Salem Met: Salem Jul-17 Non-Key 5/31/2019 None Watson-Stites, Elizabeth, PhD: (b) (6) CDRC Eugene Met: Eugene Sep-16 Non-Key 2/28/2019 None Webb, Kurt, PsyD:(b) (6) Salem Met: Salem Jul-17 Non-Key 7/31/2019 None Whitehead, Michelle, PhD: (b) (6) Bend Met: Bend Oct-17 Non-Key 6/30/2018 None Wicher, Donna, PhD: (b) (6) PDX NW Met: Beaverton Jun-16 Non-Key 2/28/2019 None Wicher, Donna, PhD: (b) (6) PDX NE Met: Clackamas Jul-17 Non-Key 2/28/2019 None Wicher, Donna, PhD: (b) (6) PDX NW Met: Hillsboro Jun-16 Non-Key 2/28/2019 None Wicher, Donna, PhD: (b) (6) PDX SE Met: Portland Jun-16 Non-Key 2/28/2019 None Wilcox, Georgia, PsyD: (b) (6) Wilcox & Associates PDX SW Met: Portland Sep-17 Non-Key 6/30/2018 None The Water Tower BLDG Wong-Nagan, Julia, PhD: (b) (6) PDX SW Met: Portland Sep-17 Booked Out 3/31/2019 None

Updated 11/09/2017 WPL OR DDS CE License Check for OT and PT FY 2016/17

Location: Region Onsite Visit Key/Volume License Provider Name or Clinic Name Provider Association (Group/Clinic) Expiration / City Month/Year Provider Number

Strode, Margaret C, OT: PDX NW Met: Ceased in Jun-16 5/31/2016 Beaverton, New Horizons Wellness Service Beaverton 4/16 (b) (6) Ethel-King, Melodie, OT: (b) (6) PDX NW Met: Non-Key Jun-16 5/31/2018 Beaverton, New Horizons Wellness Service Beaverton Provider Fouts, Stephanie M, OT: (b) (6) PDX NW Met: Non-Key Jun-16 5/31/2018 Beaverton, New Horizons Wellness Service Beaverton Provider

Updated 11/09/2017 WPL OR DDS CE Licensing for OD (E110) FY 2016/17

Onsite Visit Key/Volume License Provider Name or Clinic Name Provider Association (Group/Clinic) Location: Region / City Expiration Month/Year Provider Number Smith, Douglas, OD: (b) (6) Bison Vision Medford Metro: Medford May-15 Non-Key (b) (6) 11/30/2017 Glabe, David. OD: (b) (6) La Grande Family Eye Care Ontario Metro: La Grande TBD Non-Key 1/31/2018 Overton, Scott H, OD: (b) (6) Pacific Uni. OR PDX Fam. Vision PDX SW: Portland Sep-17 Non-Key 3/31/2018 Kimball, Samuel, OD: (b) (6) La Grande Family Eye Care Ontario Metro: La Grande TBD Non-Key 4/30/2018

Updated 11/09/2017 WPL OR DDS CE Licensing for WA State CE Providers FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration (Group/Clinic) Month/Year Provider Number

Gaffield, Gary, OP: (b) (6) MDSI-Longview Astoria Met: Longview N/A Top 5 2/20/2018 Gibson, Philip Vannoy, PhD: (b) (6) MDSI-Longview Astoria Met: Longview N/A Top 5 (b) (6) 6/26/2018 Kurdieh, Ibrahim Ishaq, PsyD: (b) (6) NW PSY Astoria Met: Longview N/A Non-Key 8/9/2018 McCulloch, Katie B, PhD: (b) (6) NW PSY Astoria Met: Longview N/A Non-Key 4/14/2018 Meharg, Stephen, PsyD: (b) (6) NW PSY Astoria Met: Longview N/A Non-Key 4/25/2020 Patterson, Alexander, PsyD: (b) (6) MDSI-Longview Astoria Met: Longview N/A Top 5 5/8/2018 St. John Medical CTR Hosp: (b) (6) X-Rays read by Longview N/A Non-Key N/A Radiologists Astoria Met: Longview Weir, Peter A, MD: (b) (6) MDSI-Longview Astoria Met: Longview N/A Top 5 6/1/2019 Providence St Mary Hosp: NE OR: Walla Walla, WA N/A Not using N/A Dooley, Tom M, PsyD: (b) (6) Cascade Executive STE N/A Non-Key 11/22/2019 PDX NE Met: Vancouver, WA

Updated 11/09/2017 WPL OR DDS CE Licensing Check for Idaho State CE Providers 2016/17

Provider Association Onsite Visit Key/Volume License SAMS Provider Name or Clinic Name Location: Region / City Expiration (Group/Clinic) Month/Year Provider Number Check

Sturmak, Michael, AuD: (b) (6) Elks Hearing & Balance Ontario Metro: Eagle N/A Non-Key 1/30/2018 Starr, David, PsyD: (b) (6) Ontario Metro: Nampa N/A Non-Key (b) (6) 3/20/2018 Doke, Jerry D, PsyD: (b) (6) Ontario Metro: Boise medical hold N/A 6/18/2018 10/17 Kent, Gregory J, MD: (b) (6) The Eye Associates Ontario Metro: Caldwell N/A Non-Key 6/30/2018 McKinnon, Ryan, MD: (b) (6) St Luke's Saltzer South Ontario Metro: Nampa Not using N/A 6/30/2018 6/17 Barnes-Perrin, Kristie, SLP: (b) (6) Elks Hearing & Balance Ontario Metro: Middleton N/A Non-Key 6/27/2019 Sant, Michael, MD: (b) (6) Idaho Phy & Rehab Med/ Ontario Metro: Meridian N/A Non-Key 6/30/2019 Idaho Elks Rehab Hos. Friedman, Robert H, MD: (b) (6) Idaho Phy & Rehab Med/ Ontario Metro: Boise Not using N/A 6/30/2019 Idaho Elks Rehab Hos. 6/17 Gem State Radiology: (b) (6) Ontario Metro: Boise N/A Non-Key N/A

Updated 10/13/2017 WPL OR DDS CE Licensing Check for California State CE Providers FY 2016/17

Provider Association Onsite Visit Key/Volume License Provider Name or Clinic Name Location: Region / City Expiration (Group/Clinic) Month/Year Provider Number Bowerman, Sara, PhD: (b) (6) Ceased using 12/16.(b) (6) Southern OR: Crescent City, CA (b) (6) N/A Ceased 12/16 12/31/2018

Sutter Coast Hospital: (b) (6) Southern OR: Crescent City, CA N/A Non-Key N/A

Updated 09/28/2017 WPL OR DDS CE On-Site Visit Log for Hospitals FY 2016/17

Location: Region / Onsite Visit Key/Volume Provider Name or Clinic Name Provider reading X-Ray X-Ray Lab PFT City Month/Year Provider

Providence Med CTR: (b) (6) Radiology Specialists of NW PC: PDX NE Met: Oct-17 Non-Key Portland Legacy Good Samaritan: (b) (6) Diagnostic Imaging NW: (b) (6) PDX NW Met: Oct-17 Non-Key Portland Peace Harbor: (b) (6) Radiology Associates PC: (b) (6) Eugene Metro: May-15 Non-Key Florence Ashland Community Not currently using. Medford Metro: May-15 Non-Key Ashland Asante Three Rivers Hosp: (b) (6) Advanced Imaging Association: Medford Metro: (b) (6) Grants Pass May-15 Non-Key

Sky Lakes MED CTR: (b) (6) Sky Lakes Outpatient Imaging: Medford Metro: (b) (6) Klamath Falls May-15 Non-Key

Providence Hospital: (b) (6) Medford Radiology Group PC: Medford Metro: Medford May-15 Non-Key

Rogue Valley MED CTR: (b) (6) Medford Radiology Group PC: Medford Metro: Medford May-15 Non-Key

Legacy Emanuel: (b) (6) PDX NE Met: Aug-15 Non-Key Portland Legacy MT Hood MED: (b) (6) Advantage LLC: PDX NE Metro: Summit Imaging: (b) (6) Gresham Aug-15 Non-Key Advantage LLC: (b) (6) Legacy Meridian Park: (b) (6) Tualatin Imaging PC: (b) (6) PDX NW Metro: Aug-15 Non-Key Tualatin Mountain View District:(b) (6) Bend Metro: Oct-15 Non-Key Madras Pioneer Memorial Hosp: (b) (6) Central OR Radiology: (b) (6) Bend Metro: Oct-15 Non-Key Prineville Grande Ronde: (b) (6) Ontario Metro: La Oct-15 Non-Key Grande ST Alphonsus Med CTR: (b) (6) Gem State Radiology (Boise): Ontario Metro: Oct-15 Non-Key (b) (6) Ontario Mid-Columbia MED: (b) (6) PDX NE Metro: Oct-15 Non-Key The Dalles ST Alphonsus Med CTR St. Alphonsus Med: Pendleton Metro: Baker City Oct-15 Non-Key

Updated 10/13/17 WPL OR DDS CE On-Site Visit Log for Hospitals FY 2016/17

Location: Region / Onsite Visit Key/Volume Provider Name or Clinic Name Provider reading X-Ray X-Ray Lab PFT City Month/Year Provider

Good Shepherd Hospital: (b) (6) Good Shepherd Hospital: Pendleton Metro: Hermiston Oct-15 Non-Key

St. Anthony: (b) (6) GEM STATE RADIOLOGY: (b) (6) Pendleton Metro: Pendleton Oct-15 Non-Key

Tuality Community Hosp: (b) (6) PDX NW Met: Feb-16 Non-Key ) Hillsboro Good Samaritan Hospital:(b) (6) Diagnostic Imaging NW: (b) (6) PDX NW Metro: Portland Feb-16 Non-Key

SAMARITAN ALBANY GENERAL Hospital Diagnostic Imaging Association: (b) (6) Albany Metro: Feb-16 Non-Key Albany Samaritan Albany Pulm (b) (6) Albany Metro: Feb-16 Non-Key Albany Good Samaritan REG MED Corvallis Radiology PC: SNLH: (b) (6) Albany Metro: (b) (6) Corvallis Feb-16 Non-Key Lebanon Community: (b) (6) Corvallis Rad. PC: (b) (6) Albany Metro: Feb-16 Non-Key Lebanon Samaritan Pacific Com: (b) (6) Samaritan PC: (b) (6) Albany Metro: Newport Feb-16 Non-Key

Mission Medical Imaging: (b) (6) Willamette Valley Radiology: Salem Metro: Feb-16 Non-Key (b) (6) Salem Salem Radiology Consult: (b) (6) Salem Metro: Feb-16 Non-Key Salem Providence Willamette Falls: (b) (6) Radiology Specialists of NW PC: PDX NE Metro: Jun-16 Non-Key Oregon City Providence Milwaukie: (b) (6) Radiology Specialists of NW PC: PDX NE Metro: Jun-16 Non-Key Milwaukie Providence St Vincent: (b) (6) Medford Radiology Group PC: TRG PDX NW Metro: Jun-16 Non-Key LLC: Portland Portland Adventist Med: (b) (6) Diagnostic Radiologists: PDX SE Metro: Jun-16 Non-Key (b) (6) Portland Oregon Imaging CTR: (b) (6) Radiology Associates PC: (b) (6) Eugene Metro: Sep-16 Non-Key Eugene Peace Health Sacred Heart: (b) (6) Radiology Associates PC: (b) (6) Eugene Metro: Sep-16 Non-Key Eugene McKenzie Willamette MED: (b) (6) Eugene Metro: Springfield Sep-16 Non-Key

Updated 10/13/17 WPL OR DDS CE On-Site Visit Log for Hospitals FY 2016/17

Location: Region / Onsite Visit Key/Volume Provider Name or Clinic Name Provider reading X-Ray X-Ray Lab PFT City Month/Year Provider

Southern Coos Gen. Hospital: (b) (6) Southern Coos Hospital: Medford Metro: Sep-16 Non-Key Bandon Curry Med CTR Medford Radiology Group PC: Medford Metro: Brookings Sep-16 Non-Key

Curry General Hospital: (b) (6) Medford Metro: Gold Beach Sep-16 Non-Key

Bay Area / NBMC: (b) (6) Bay Area Radiology PC: Roseburg Metro: (b) (6) Coos Bay Sep-16 Non-Key

Coquille Valley Not currently using. Roseburg Metro: Sep-16 Non-Key Coquille Lower Umqua Hospital: 050004578-(b) (6) The read their own x-rays. Roseburg Metro: Reedsport Sep-16 Non-Key

Mercy MED CTR INC: (b) (6) MMC Respiratory Therapy: Roseburg Metro: (b) (6) Roseburg Sep-16 Non-Key

Samaritan North Lincoln:(b) (6) SNLH: Salem Metro: Corvallis Rad. PC: (b) (6) Lincoln City Sep-16 Non-Key

Tuality Forest Grove Hosp: Not currently using. PDX SW Metro: Oct-16 Non-Key Forest Grove Salem Hospital: (b) (6) Salem Metro: Jul-17 Non-Key Salem Salem Pulmonary Associates: (b) (6) Salem Metro: Jul-17 Non-Key Salem Columbia Memorial Hosp: (b) (6) Astoria Metro: Sep-17 Non-Key Astoria Providence Seaside: (b) (6) Oregon Coast Radiology: (b) (6) Astoria Metro: Sep-17 Non-Key Seaside Tillamook Regional Med: Tillamook County Gen Astoria Metro: Hospital: (b) (6) Tillamook Sep-17 Non-Key

OHSU: (b) (6) PDX SW Metro: Oct-17 Non-Key Portland Salem Health West Valley Hospital: (b) (6) West Valley Hospital: Salem Metro: Oct-17 Non-Key Dallas Santiam Memorial:(b) (6) Salem Metro: Oct-17 Non-Key Stayton Updated 10/13/17 WPL OR DDS CE On-Site Visit Log for Hospitals FY 2016/17

Location: Region / Onsite Visit Key/Volume Provider Name or Clinic Name Provider reading X-Ray X-Ray Lab PFT City Month/Year Provider

St. Charles MED CTR Central OR Radiology: Bend Metro: Bend Oct-17 Non-Key

Central Oregon District:(b) (6) Central OR Radiology: (b) (6) Bend Metro: Redmond Oct-17 Non-Key

Willamette Valley MED: (b) (6) McMinnville Imaging Assoc: Salem Metro: Oct-17 Non-Key (b) (6) McMinnville Providence Newberg Hosp: (b) (6) TRG LLC: (b) (6) Salem Metro: Oct-17 Non-Key Newberg St. John Medical CTR: (b) (6) Longview Radiologists:(b) (6) Astoria Metro: N/A Non-Key Longview Central Oregon Radiology: (b) (6) Cascade Medical Imaging: Bend Metro: Bend TBD Non-Key

Harney District: (b) (6) Bend Metro: TBD Non-Key Burns Asante Three Rivers Imaging: (b) (6) Advanced Imaging Association: Medford Metro: Cave Junction TBD Non-Key

Mid Rogue Imaging CTR: Advanced Imaging Assoc. Medford Metro: (X-Rays) Grants Pass TBD Non-Key

Wallowa Memorial Hosp: (b) (6) Central OR Radiology: (b) (6) Ontario Metro: TBD Non-Key Enterprise Blue Mountain:(b) (6) Ontario Metro: TBD Non-Key John Day Providence Hood River: (b) (6) Chad Foster, MD: (b) (6) PDX NE Metro: TBD Non-Key Hood River Silverton Health: (b) (6) Diagnostic Imaging Association: Salem Metro: TBD Non-Key (b) (6) Silverton

Updated 10/13/17 WPL OR DDS CE License Check AuD (T111) and SLP (E112) FY 2016/17

Provider Association Onsite Visit Key/Volume License SAMS Provider Name or Clinic Name Location: Region / City Expiration (Group/Clinic) Month/Year Provider Number Check

Leavitt, Ron, AuD: (b) (6) Corvallis Hearing CTR Hearing Albany Metro: Corvallis Sep-16 Non-Key (b) (6) 1/30/2018 None Assis. Tech. Richards, Corry, AuD: (b) (6) Central OR Audiology Bend Metro: Bend Oct-15 Non-Key 1/30/2018 None Kenyon, Janet, AuD: (b) (6) Kenyon Audiology Bend Metro: Bend Oct-17 Non-Key 1/30/2018 None Bacuyani, Angela M, SLP: (b) (6) Redmond S&L Rosie Barels Com. Bend Metro: Bend Oct-17 Non-Key 1/30/2018 None Campus Bacuyani, Angela M, SLP: (b) (6) Redmond S&L Rosie Barels Com. Bend Metro: Redmond Oct-17 Non-Key 1/30/2018 None Campus Stevenson, Christina, SLP: (b) (6) Redmond S&L Rosie Barels Com. Bend Metro: Redmond Oct-17 Non-Key 1/30/2018 None Campus Canavan, Alycia, SLP: (b) (6) Birdsong Speech Therapy Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 None Associates Embry, Hannah, SLP: (b) (6) Birdsong Speech Therapy Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 None Associates Harden, Barbara, SLP: (b) (6) CDRC Eugene Metro: Eugene Sep-16 Non-Key 1/30/2018 None Sloan, Jayme W, SLP: (b) (6) Birdsong Speech Therapy Eugene Metro: Eugene Sep-16 Non-Key 1/31/2018 None Associates Walker, Jill, SLP: (b) (6) Asante Rogue Reg. Med. CTR Medford Metro: Grants May-15 Non-Key 1/30/2018 None Pass Guthrie, Dana , SLP: (b) (6) Jungle Gym-Ped Therapy CTR Medford Metro: TBD Non-Key 1/30/2018 None Klamath Falls Du Brey, Louis, AuD: (b) (6) Basin Audiology Medford Metro: Not using May-15 1/30/2018 None Klamath Falls 6/16 Wu, Amber Nicole AuD: (b) (6) Basin Audiology Medford Metro: May-15 Non-Key 1/30/2018 None Klamath Falls Horton, Christine A, SLP: (b) (6) Asante Rogue Reg. Med. CTR Medford Metro: May-15 Non-Key 1/30/2018 None Medford Culligan, Tiffaney, SLP: (b) (6) New Horizons Wellness PDX NW Metro: Jun-16 Non-Key 1/30/2018 None Service Beaverton Borgmeyer, Gregory, AuD: (b) (6) Adventist Health Medical CTR PDX NW Metro: PDX Jun-16 Non-Key 1/30/2018 None ENG Jones, Erika C, AuD: (b) (6) Adventist Health Medical CTR PDX NW Metro: PDX Jun-16 Non-Key 1/30/2018 None ENG Grenz-Neb, Melaney, SLP: (b) (6) Marshall BLDG PDX NW Metro: PDX Mar-15 Non-Key 1/30/2018 None

Updated 10/13/2017 WPL OR DDS CE License Check AuD (T111) and SLP (E112) FY 2016/17

Provider Association Onsite Visit Key/Volume License SAMS Provider Name or Clinic Name Location: Region / City Expiration (Group/Clinic) Month/Year Provider Number Check

Eggleston, Jessica L, AuD: (b) (6) OHSU Cochlear Implant PDX SW Metro: PDX Oct-17 Non-Key (b) (6) 1/30/2018 None Program. Lakin, Carrie, E, AuD: (b) (6) OHSU Cochlear Implant PDX SW Metro: PDX Oct-17 Non-Key 1/30/2018 None Program. Middaugh, Jessica, AuD: (b) (6) OHSU Cochlear Implant PDX SW Metro: PDX Oct-17 Non-Key 1/30/2018 None Program. Van Auken, Jessica, AuD: (b) (6) OHSU Cochlear Implant PDX SW Metro: PDX Oct-17 Non-Key 1/30/2018 None Program. Wilson, Brittany, AuD: OHSU Cochlear Implant PDX SW Metro: PDX Oct-17 Non-Key 1/30/2018 None Program. Knowles, Genessa SLP: (b) (6) Good Shepherd Mec. CTR S&L Pendleton Met: Oct-15 Non-Key 1/30/2018 None Dept. Hermiston Price, Jennie, SLP: (b) (6) Good Shepherd Mec. CTR S&L Pendleton Met: Oct-15 Non-Key 1/30/2018 None Dept. Hermiston Seitz, Regina L, SLP: (b) (6) Good Shepherd Mec. CTR S&L Pendleton Met: Oct-15 Non-Key 1/30/2018 None Dept. Hermiston Wu, Tong, SLP: (b) (6) Good Shepherd Mec. CTR S&L Pendleton Met: Oct-15 Non-Key 1/30/2018 None Dept. Hermiston Tuning - Heid, Lacey A, SLP: (b) (6) Good Shepherd Mec. CTR S&L Pendleton Met: Not using as Oct-15 1/30/2018 None Dept. Hermiston of 6/17 Wing, Karen, SLP: (b) (6) Grand Ronde Hospital Pendleton Met: La Oct-15 Non-Key 1/30/2018 None Grande Anderson, Renata, AuD: (b) (6) Pendleton Met: Oct-15 Non-Key 1/30/2018 None Pendleton Landsberg , Todd, AuD: (b) (6) S. Coast Hearing Pacific View Roseburg Metro: Coos Sep-16 Non-Key 1/30/2018 None Bay Kornbau, James, AuD: (b) (6) Roseburg Metro: Not Using N/A 1/30/2018 None Coquille 6/17 Sheldon-Felton, Melodie, SLP: (b) (6) Sheldon Med / SW Rehab. Roseburg Metro: North Sep-16 Non-Key 1/31/2018 None Bend Hull, Heather M, SLPL: (b) (6) Redmond S&L Rosie Barels Com. Roseburg Metro: Sep-16 Ceased 7/17 1/30/2018 None Campus Roseburg Grenz-Neb, Melaney, SLP: (b) (6) Salem Metro: Salem Jun-17 Non-Key 1/30/2018 None

Updated 10/13/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

Smolen, Gail, MD: (b) (6) Piercey Neurology LLC Albany Metro: Albany Feb-16 Non-Key 12/31/2017 None Not using Lees, John, MD: (b) (6) Eye Care Associates Albany Metro: Albany Non-Key (b) (6) 12/31/2017 None 6/17 Madsen, Bruce, MD: (b) (6) Eye Care Associates Albany Metro: Albany Feb-16 Non-Key 12/31/2017 None Vanderwaal, Steven, C, MD: (b) (6) Astoria Metro: Gearhart Sep-17 Non-Key 12/31/2017 None Henderson, Michael D, DO: (b) (6) Bend Metro: Bend Oct-17 Top 5 12/31/2017 None Dimmig, Jason, MD: (b) (6) Bend Opthomology Bend Metro: Bend Oct-17 Non-Key 12/31/2017 None Villano, Michael E, MD: (b) (6) Bend Metro: Bend Oct-17 Non-Key 12/31/2017 None Lieuallen, Douglas W, MD: (b) (6) Madras Medical Group PC Bend Metro: Madras Not using Non-Key 12/31/2017 None 1/17 Knackstedt, James J, MD: (b) (6) OR ENT Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 None MDSI: Eugene: (b) (6) Eugene Metro: Eugene Sep-16 Top 5 N/A None Karren, Kent A, MD: (b) (6) The Eye CTR Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 None Nickel, Robert E, MD: (b) (6) CDRC Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 None Petersen, Mario C, MD: (b) (6) CDRC Eugene Metro: Eugene Sep-16 Non-Key 12/31/2017 None Ahmad, Mahnaz, MD MDSI MDSI N/A N/A 12/31/2017 None Bommiasamy, Aravind, MD MDSI MDSI N/A N/A 12/31/2017 None Bruns, Maureen P, MD: MDSI MDSI N/A N/A 12/31/2017 None Curtis, Zane, MD: (Psychiatrist) MDSI MDSI N/A N/A 12/31/2017 None Cvijanovic, Milela, MD MDSI MDSI N/A Ceased 10/16 12/31/2017 None Engelhardt, Bridgette, MD MDSI MDSI N/A N/A 12/31/2017 None Fillingame, Ralph A, MD: MDSI MDSI N/A N/A 12/31/2017 None Ge, Haitao, MD MDSI MDSI N/A N/A 12/31/2017 None Gibbs, Angela, MD: MDSI MDSI N/A N/A 12/31/2017 None Harrison, Johnathan, MD MDSI MDSI 12/31/2017 N/A Ceased 10/16 None Harvey, Sydney, DO MDSI-Psychiatrist MDSI New Job N/A 12/31/2017 None 10/16 Hoop, Heather E, MD MDSI MDSI N/A N/A 12/31/2017 None Howerter, Stephanie S, MD: MDSI MDSI N/A N/A 12/31/2017 None Hubbard, Stepeh D, DO MDSI MDSI Ceased 11/16 N/A 12/31/2017 None Bussy

Updated 10/23/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

Kauffman, Darrel, MD MDSI MDSI N/A N/A (b) (6) 12/31/2017 None Kelley, Katherine, MD MDSI MDSI 1/1/2018 N/A N/A None Khaleeq, Erum, MD (Psychiatrist) MDSI MDSI DDS ceased N/A 12/31/2017 None using 3/17 Kujac, Tany, MD MDSI MDSI N/A N/A 12/31/2017 None Maughan, Cory, DO MDSI MDSI N/A N/A 12/31/2017 None Nguyen, Khanh, MD MDSI MDSI N/A N/A 12/31/2017 None Olshausen, K Philipp, MD: MDSI MDSI N/A Ceased 2/17 12/31/2017 None Richmond, Judith, MD: MDSI MDSI N/A N/A 12/31/2017 None Sanchez, Katherine Guadalupe, MD: MDSI MDSI N/A N/A 1/1/2017 None Selinger, Daniel, MD MDSI MDSI N/A N/A 12/31/2017 None Siegal, Steven R, MD: MDSI MDSI N/A Ceased 10/16 12/31/2017 None Snider, Karla Pivik, MD: MDSI MDSI N/A Ceased 10/16 12/31/2017 None Thomas, Scott R, DO MDSI MDSI N/A Ceased 10/16 12/31/2017 None Urion, Frank A, DO MDSI MDSI Ceased N/A 12/31/2017 None 4/3/17 Williams, Nadine, MD MDSI MDSI N/A N/A 12/31/2017 None Zarour, Luai, MD: MDSI MDSI N/A N/A 12/31/2017 None

Deatherage, Mark F, MD: (b) (6) Grants Pass Surgical Assoc. Medford Metro: Grants Pass May-15 Non-Key 12/31/2017 None (Vascular) Henderson, Michael, DO: (b) (6) Medford Metro: Klamath Falls May-15 Top 5 12/31/2017 None Hufnagel, Deanne M, DO: (b) (6) Sandfords Children's Medford Metro: Klamath Falls May-15 Only their PT 12/31/2017 None Stevens, Scott K, MD: (b) (6) Klamath Eye CTR Medford Metro: Klamath May-15 Non-Key 12/31/2017 None Falls

Updated 10/23/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

Wingerter, Jacob J, MD: (b) (6) Sandfords Children's Medford Metro: Klamath Falls May-15 Only Their PT (b) (6) 12/31/2017 None Barrus, Loren R, MD: (b) (6) Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None Chambers, David, MD: (b) (6) Oregon ENT CTR Medford Metro: Medford May-15 Non-Key 12/31/2017 None MDSI: Medford: (b) (6) Medford Metro: Medford May-15 Top 5 N/A None Reeck, Jay B, MD: (b) (6) Oregon ENT CTR Medford Metro: Medford May-15 Non-Key 12/31/2017 None Rutar, Tina, MD: (b) (6) Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None Schultz, Paul N, MD:(b) (6) Cataract Laser Inst. of S. OR Medford Metro: Medford May-15 Non-Key 12/31/2017 None Solomon, Jeffrey A, DO: (b) (6) Rehab Med Physicians Medford Metro: Medford May-15 Non-Key 12/31/2017 None

Stark, Frank, MD: (b) (6) Ontario Metro: Oct-15 Non-Key 12/31/2017 None Sant, Michael, MD: (b) (6) Idaho Phy & Rehab Med/ Ontario Metro: Ontario Oct-15 Non-Key 12/31/2017 None Idaho Elks Cannon, Daniel E, MD: (b) (6) Columbia Gorge ENT PDX NE Metro: The Dalles Not willing TBA 12/31/2017 None 02/17 Leinenbach, Derek J, MD: (b) (6) PDX NE Metro: The Dalles Oct-17 Non-Key 12/31/2017 None Janselewitz, Steve J, MD: (b) (6) Legacy Rehab Emanuel Ped. PDX NE: Portland Aug-15 Non-Key 12/31/2017 None Pedersen, Andrew D, MD: (b) (6) The OR Clinic / ENT Plaza PDX NE: Portland Aug-15 Non-Key 12/31/2017 None Rufener, Justin B, MD: (b) (6) The OR Clinic / ENT Plaza PDX NE: Portland Aug-15 Non-Key 12/31/2017 None Scott, Garrett R, MD: (b) (6) Hillsboro Eye Clinic PC PDX NW Metro: Hillsboro Jun-16 Non-Key 12/31/2017 None Ogisu, Tatsuro, MD: (b) (6) Marshall BLDG PDX NW: Marshall BLDG Mar-15 Non-Key 12/31/2017 None Leinenbach, Derek J, MD: (b) (6) PDX NW: Portland Sep-17 Top 5 12/31/2017 None

Updated 10/23/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

Webster, Kim B, MD: (b) (6) Rejuvenation Med Clinic PDX NW: Portland Mar-15 Non-Key (b) (6) 12/31/2017 None Ellison, John H, MD: (b) (6) Sellwood Medical Clinic PDX SE: Portland Aug-15 Non-Key 12/31/2017 None Kim, Shane C, MD: (b) (6) Eye Health NW PDX SE: Portland Jun-16 Non-Key 12/31/2017 None Saulson, Roger M, MD: (b) (6) Eye Health NW PDX SE: Portland Jun-16 Non-Key 12/31/2017 None Almaraz, Lewis, MD: (b) (6) Office space at Exam Works PDX SW: Portland May-16 Non-Key 12/31/2017 None Blasco, Peter, MD: (b) (6) CDRC Doernbecher PDX SW: Portland Oct-17 Non-Key 12/31/2017 None

Wolf, Solomon, MD: (b) (6) UPBHS PDX SW: Portland May-16 Non-Key 12/31/2017 None Sethi, Sushil Mittar, MD: (b) (6) True Health Medicine PDX SW: Tualatin Jul-17 Non-Key 12/31/2017 None Lubahn, Jordon, MD: (b) (6) Eye Health NW PDX: SW Portland Jun-16 Non-Key 12/31/2017 None McGlynn, Robert, MD: (b) (6) Eye Health NW PDX: SW Portland Jun-16 Non-Key 12/31/2017 None Davis, James Edward, MD: (b) (6) Pendleton Metro: Baker City Oct-15 Non-Key 12/31/2017 None Hofmann, Charles, MD: (b) (6) Pendleton Metro: Baker City Oct-15 Ceased 04/17 12/31/2017 None Petrusek, Joseph L, MD: (b) (6) Audio & Hearing Aid Assoc. Pendleton Metro: La Grande Oct-15 Non-Key 12/31/2017 None Deitz, Michael E, MD: (b) (6) Deitz & Warner share office Pendleton Metro: Pendleton Oct-15 Non-Key 12/31/2017 None Henderson, Michael D, DO: (b) (6) Pendleton Metro: Pendleton Oct-15 Top 5 12/31/2017 None Warner, Michael A, MD: (b) (6) Deitz & Warner share office Pendleton Metro: Pendleton Oct-15 Retired 4/17 12/31/2017 None MDSI: Portland: (b) (6) Portland Metro: Sep-17 Top 5 N/A None McKelvey, Carla D, MD: (b) (6) North Bend MED CTR Roseburg Metro: Coos Bay Sep-16 Non-Key 12/31/2017 None

Updated 10/23/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

MDSI: Coos Bay: (b) (6) MDSI Roseburg Metro: Coos Bay Sep-16 Top 5 (b) (6) N/A None Gilbert, Jane, MD: (b) (6) Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None Graham, Debra A, MD: (b) (6) Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None Nolan, Raymond P, MD (b) (6) Waterfall Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None Ottemiller, Dennis E, MD: (b) (6) Bay Eye Clinic Roseburg Metro: North Bend Sep-16 Non-Key 12/31/2017 None Gregg, Patrick J, MD (b) (6) Umpqua Valley Eye Roseburg Metro: Roseburg Sep-16 Non-Key 12/31/2017 None Leinenbach, Derek J, MD: (b) (6) Roseburg Metro: Roseburg Sep-16 Top 5 12/31/2017 None Blake, Eric, MD: (b) (6) Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None Brumbaugh, Raymond, MD: (b) (6) Salem Rehabilitation Salem Metro: Keizer Jul-17 Retired 07/17 12/31/2017 None French, John A, MD: (b) (6) Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None Hook, James D, MD: (b) (6) Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None Truong, D X Steve, MD: (b) (6) Salem Rehabilitation Salem Metro: Keizer Jul-17 Non-Key 12/31/2017 None Leinenbach, Derek J, MD: (b) (6) Salem Metro: Lincoln City Jul-16 Top 5 12/31/2017 None Nolan, Raymond P, MD (b) (6) McMinnville Internal Salem Metro: McMinnville Oct-17 Non-Key 12/31/2017 None Medicine Berzins, John, MD: (b) (6) Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None Dodd, John G, DO: (b) (6) Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None East, Marcus A, MD: (b) (6) Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None Lapour, Ryan W, MD: (b) (6) Medical Center Eye Clinic Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Updated 10/23/2017 WPL OR DDS CE License Check for MD and DO FY 2016/17

Provider Association Onsite Visit Key/Volume Provider Name or Clinic Name Location: Region / City License Number Expiration Sams Check (Group/Clinic) Month/Year Provider

MDSI: Salem: (b) (6) Salem Metro: Salem Jun-17 Top 5 (b) (6) N/A None Tibolt, Robert Earl, MD: (b) (6) Medical Center Eye Clinic Salem Metro: Salem Not using as Jun-17 12/31/2017 None of 2015 Allan, Joseph, MD: (b) (6) Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None Donovan, J. Stephen, MD: (b) (6) Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Ellison, John H, MD: (b) (6) Salem Metro: Salem Jul-17 Non-Key 12/31/2017 None Johnson, Bruce C, MD: (b) (6) Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None Skarada, Douglas, MD: (b) (6) Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None Thompson, Clark R, MD: (b) (6) Willamette ENT Salem Metro: Salem Jun-17 Non-Key 12/31/2017 None

Updated 10/23/2017 WPL Provider Date Claim # Complaint (b) (6) Table of Contents

Notes: Conduct reviews montly and place documentation in the log State Source Web Address book. Board of Not currently using providers in CA for this specialty. N/A California Psychology Board of Not currently using providers in CA for this specialty. N/A California Medicine Board of Not currently using providers in CA for this specialty. N/A California Optometry Board of SLP & Not currently using providers in CA for this specialty. N/A California AuD Not currently using providers in CA for this specialty. N/A California Board of OT & PT Board of https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser.aspx?B Click on Disciplinary Action found towards the bottom of the column Idaho Psychology ureau=PSY on the left hand side. Board of https://isecure.bom.idaho.gov/BOMPublic/FormalActionBrowser.aspx?B Click on Disciplinary Action found towards the bottom of the column Idaho Medicine oard=BOM on the right hand side. Board of SLP & https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser.aspx?B Click on Disciplinary Action found towards the bottom of the column Idaho AuD ureau=SHS on the left hand side. Board of https://secure.ibol.idaho.gov/eIBOLPublic/FormalActionBrowser. Click on Disciplinary Action found towards the bottom of the column Idaho Optometry aspx?Bureau=OPT on the right hand side. Board of The link for the Disciplinary Action Report is found in the lower right Oregon http://www.oregon.gov/OBPE/pages/index.aspx Psychology hand corner of the page. Board of https://techmedweb.omb.state.or.us/Clients/ORMB/Public/Verifi The board has a monthly email notification of disciplinary actions. Oregon Medicine cationRequest.aspx Board of http://www.oregon.gov/obo/pages/index.aspx Click on Disciplinar Actions link found in the midle under Consumer Oregon Optometry Information. Click on (The Listing PDF) http://www.oregon.gov/bspa/Pages/index.aspx Click link labled Past Disciplinary Actions which is on the left hand side. Board of SLP & Oregon Click on Recent Board actions found at the bottom of the list. AuD http://www.oregon.gov/OTLB/pages/index.aspx This board does not post disciplinary actions. OR DDS only uses two Oregon Board of OT & PT providers and so I manually go in and check their license.

The WA web site is difficult to manuver. We only use a few providers Washington Covers all boards https://fortress.wa.gov/doh/providercredentialsearch/ and so I just look each up individually.

Updated 06/05/2017 Table of Contents

https://www.sam.gov/portal/SAM/?navigationalstate=JBPNS_rO0ABXdc Update CE Panel when MDSI providers are added/deleted. Individual ACJqYXZheC5mYWNlcy5wb3J0bGV0YnJpZGdlLlNUQVRFX0lEAAAAAQApd CE providers added by the CE Scheduling unit are automaticlly mlldzoxMmQyZjU4MS1hM2Q4LTQwYmEtYjIyOC02M2Q2NDFlODdmYzU included in the SAMS review. Send an email to Bugbustes 1x per Covers all SAMS AB19fRU9GX18*&portal:componentId=31be779b-ffb7-4907-b7b1- month and ask them to run a quary. They will email a response. Place providers e74a85af25d6&interactionstate=JBPNS_rO0ABXc3ABBfanNmQnJpZGdlV a copy in the Log Book. mlld0lkAAAAAQAWL2pzZi9kYnNpZ2h0U2VhcmNoLmpzcAAHX19FT0ZfX w**&portal:type=action%20-%201#1#1

Updated 06/05/2017 PA FY 2017 CE Providers IMA GROUP - KEY/VOLUME PROVIDER Adam, Stephanie* Psychology Ahdieh, Houman Ophthalmology Ahmed, Rafay * Nuclear Alberico-Rarig, Terry CRNP/Family Health Amexo, Kwaku Physician/Surgeon Amundson, Russell Physician/Surgeon Amuth, Aravindan Physician/Surgeon Anon, Jack Otolaryngology Anzalone, Anthony Physician/Surgeon Avelino, Verenys Speech and Hearing Baker, David Psychology Barras, David Otolaryngology Benedict, Elysia Psychology Berkowitz, Carl Optometry Betancourt, Laura Psychology Betts, Jennifer Psychology Billings, Rebecca Psychology Boerio, Margaret Osteophathic Physician and Surgeon Bralow, Scott Osteophathic Physician and Surgeon Brodie, Elizabeth Ann Speech and Hearing Broll-Barone, Bruno Psychology Broska, Arlene Psychology Cannon, Megan Psychology Canseco-Berbano, Rachel Physician/Surgeon Cantwell, Renee * Psychology Carroll, Sean Osteophathic Physician and Surgeon Chapman, Mark Psychology Cherfas Tysvine, Irene Ophthalmology Chiodo, Angela Psychology Choudry, Abaid Physician/Surgeon Christophe, Kathleen Physician/Surgeon Christopher, Mark * Pathology Coaxum, Barbara Speech and Hearing Colbert, April Psychology Cole, Andrew Psychology Coleman, Gregory Psychology Connell, Tammy Psychology Coons, Krista Psychology Cox, Kylie Ann Speech and Hearing Crichlow, Brook Psychology Davis, Tommy III Psychology Deines, Chantal Psychology Dillon, Mary Psychology Dinovitser, Jay Internal Medicine Donoughe, Jennifer Speech and Hearing D'Orazio, Nicholas Internal Medicine Dorshimer, Brian Psychology Doyle, Kimberly Psychology Dubro, Alan Psychology Dzurinko, David Obstetrics and Gynecology Evanov, Amy M Speech and Hearing Evans, David Optometry Fask, David Psychology Fleischman, Sari Psychology Formica, Armand Physician/Surgeon Fornelli, Rick Otolaryngology Friedman, Marsha Psychology Frommer, James Osteophathic Physician and Surgeon Giacomelli, Jodi Psychology Gibbings, Elisabeth Psychology Gipe, Christopher* Psychology Goldman, Tatyana Physician/Surgeon Golman, Stacy Psychology Gower, Maggie H* Speech and Hearing Grabon, Gregory Physician/Surgeon Grasso-Megyeri, Dawn M Speech and Hearing Groves, Lindsey Psychology Hahn, Richard Internal Medicine Hartman, Brett Psychology Haytmanek, Craig Physician/Surgeon Heskeyahu, Tammy Psychology Hoffman, Jill Audiology Hoffman, Kevin Psychology Houseman, Joshua Psychology Huitt-Corcoran, Carla Physician/Surgeon Hunt, Raselette Family Hunter, Pamela Speech and Hearing Jabbour, Victor Internal Medicine Jacobs, Jeanne Marie Speech and Hearing Jaffe, Marc* Osteophathic Physician and Surgeon Jahan, Sarwat Internal Medicine Jenouri, Gilbert Internal Medicine Johnson, Charles Psychology Kakodkar, Vasundhara Pediatrics Kaplan, Richard Physical Medicine & Rehab Karpf, Ronald Psychology Katz, Michael Optometry Kennedy, Charles Psychology Kibler, Lindsay Optometry Klebanoff, David Obstetrics and Gynecology Kneifati, Ahmed Orthopedic Surgery Kochan-Dewey, Amanda Psychology LaGattuta, David J Audiology LaJeunesse, Charles Psychology Lane, Thomas Psychology Ledermann, Kathleen Psychology Leighty, Danielle Psychology Lewis, Irwin Physician/Surgeon Lindner, Marged Psychology Lipman, Sidney Otolaryngology Lombardi, Gina Psychology Mackaronis, Anthony Obstetrics and Gynecology Magurno, Justine Internal Medicine Malik, Mohammad Internal Medicine Mass, Stephen * Physician/Surgeon McGettigan, Patricia Psychology McHugh, Patrick Psychology McNeill, Daniel Physical Medicine & Rehab Meltzer, Danielle Psychology Michael, Gregory Psychology Miller, Andrew W Optometry Miller, Anne Psychology Miller, John Laurence Psychology Miller, Leslie Optometry Miller, Randall Physician/Surgeon Missry, John Ophthalmology Moci, Elona Psychology Monfared, Ziba Rahjoi Physician/Surgeon Moore, Jared Psychology Nave, Peggy Psychology Newman, T. David Psychology Nichols, Trent Physician/Surgeon Nires, Avi Psychology Nwosu, Caleb Physician/Surgeon O'Connell, David * Psychology O'Donnell, Peter Psychology Olivero, Daniel Pediatrics Olivetti, Jennifer Psychology Ortiz, Joseph Ophthalmology Osachy, Lisa Psychology Pacansky, Michelle Speech and Hearing Pacella, Steven Psychology Parameswaran, Ramalingaier * Physician/Surgeon Patrone, Christopher Psychology Peterson, Renee Optometry Pietralczyk, Kari Ann Audiology Popovic, Jadranka Pediatrics Primavera, Joseph Psychology Pulver, David Internal Medicine Rabinovich, Einat Internal Medicine Rafferty-Hornung, Karen Psychology Ramirez, Renato Physician/Surgeon Reed, Kindra Speech and Hearing Reese, Christopher Psychology Reinholt, Arthur Optometry Rendall, Lisa Psychology Richards, Jennifer Psychology Robins, Michele Psychology Rogers, Robert Optometry Roscoe, Gregory ENT Rosenberg, Michael Physician/Surgeon Ruffin, Danielle Speech and Hearing Sabeh, Christina Physician/Surgeon Sanders, Scott Optometry Schell, Stephen Otolaryngology Schlesinger, Julie Megan Speech and Hearing Schmidt, Margaret Speech and Hearing Schuman, Michael Psychology Schwarzbaum, Jeremy Psychology Seltzer, Charles Internal Medicine Siokos, Zissie Optometry Slowik, Amanda Psychology Smith-Demain, Alexandra Internal Medicine Springer, Sarah Psychology Spurgeon, Monica Speech and Hearing St Thomas, Lindsay Psychology Starling, Carrie Johanna Speech and Hearing Steele, Cheryl Speech and Hearing Stein, Elicia* Psychology Stepp, Mark Optometry Strohecker, Robert Optometry Stuart, Jane Speech and Hearing Tardibuono, John Psychology Tarner, Kathryn Speech and Hearing Trafican, Sarah Psychology Trogner, Stacy Psychology Vittone, Daniel Physician/Surgeon Vittone, Michael Ophthalmology Vittone, Ronald Ophthalmology Voulo, Alyse Speech and Hearing Waters, Najah Simone Physician/Surgeon Waxman, Howard Mark Psychology Weinberger, Mark Psychology Wells, Amy Psychology Wexler, Sonya Physician/Surgeon Williams, Latoya Nicole Audiology Wolfe, William Physician/Surgeon Woll, Andrea Physician/Surgeon Wright, Michael Psychology Zehrung, David Psychology Zibelman, Mark Internal Medicine Zimmerman, Kimberly Optometry Report Date: 11/13/2017 A List of CE Vendor who Performed CEs DOS in FY 2017 (CEVENFY/HUALIB) South Carolina FY 2017

Name Column1 Column2 Vendor# City

Key provider site review made

ABBEVILLE AREA MEDICAL CENT ABBEVILLE ABNEY, LUCAS D (b) (6) COLUMBIA ABUSHAKRA, KIMBERLY A site review NORTH MYRTLE BEACH ADAIR, BRIAN ROCK HILL ADVANCED DIAGNOSTIC IMAGING ORANGEBURG AFULUKWE, FOSTER HEATH SPRINGS AGHA, AMIR ANDERSON AIKEN OPHTHALMOLOGY AIKEN AIKEN REG MEDICAL CENTER AIKEN ALEXANDER, WILLIAM T SUMTER ALLENDALE COUNTY HOSPITAL FAIRFAX ALLEYNE, WILLIAM ROCK HILL ALSFELD, L CLARK MT PLEASANT ALSFELD, LEONARD CLARK FLORENCE ALSTON, SANDRA ORANGEBURG ANDERSON RADIOLOGY ANDERSON ANDERSON, BRYAN K FORT MILL ANDERSON, EINAR W COLUMBIA ANDERSON-OCONEE SPCH & HEAR SENECA ANDREWS, DAVID N BISHOPVILLE ANGEL OAK EYE CENTER JOHNS ISLAND ANGEL, ALANNA E DUE WEST ANGUELOVA, DORA site review MURRELLS INLET ANMED HEALTH ANDERSON BONE/ ANDERSON ANMED HEALTH CAMPUS ANDERSON ANMED HEALTH MEDICAL CENTER ANDERSON ARMSTRONG, HEATHER ABBEVILLE ARMSTRONG, LINDSAY GREENVILLE ARROJAS, ALFREDO J Top 5/Med Plus site review COLUMBIA ASQUITH, SALLY A site review SUMMERVILLE ATKINS, JENNIFER LYNN site review SPARTANBURG AXFORD, MARK site review WALTERBORO AXSON, WILLIAM A SENECA BANG, DAVID W site review LADSON BAPTIST EASLEY HOSPITAL EASLEY BARKAND, DIXIE JOHNS ISLAND BARRELL, KELLY PORT ROYAL BARRETT, RHONDA V ROCK HILL BARTELL, LARRY D FORT MILL BEATY EYE CLINIC & ASSOCIAT site review BENNETTSVILLE BEAUFORT MEMORIAL HOSPITAL (b) (6) BEAUFORT BECKETT, TAMARA site review AIKEN BEHAVIORAL SYSTEMS LLC CHARLESTON BELL, THADDEUS J site review NORTH CHARLESTON BELL, WOODROW Top 5/Med Plus site review SPARTANBURG BENEDICT, REBECCA SPARTANBURG BENNETT, KIKI T AIKEN BENNETT, NICOLE G VARNVILLE BENNICE, JENNIFER A site review CHARLESTON (b) (6) (b) (6) /removed from panel BENOIT-FISCHER, CAROL E EMOVED (b) (6) ORANGEBURG BERNAT, JEFF CLEMSON BERRY, WALTER S WEST COLUMBIA BETHEA, JAMES site review CHARLESTON BLAKER, ALAN M FLORENCE BLEDSOE, HORACE W COLUMBIA BLUBAUGH, MICHAEL R site review WALTERBORO BLUFFTON MEDICAL CAMPUS BLUFFTON BOGART, WALT WEST COLUMBIA BOHAC, PAUL W JOHNS ISLAND BOLLIN, EMILY HILTON HEAD BON SECOURS ST FRANCIS XAVI CHARLESTON BOORMAN, JILL M site review NORTH CHARLESTON BOYD, C CLARK AIKEN BRACKIN, CHERYL SAVANNAH BRADLEY, JOHN B AIKEN BRASHEARS, REBECCA GREENWOOD BRIDGEWATER, LISA G site review ROCK HILL BRITT, MORRIS F CHARLOTTE BROWN, BRUCE COLUMBIA BROWN, DAVID E JR SUMTER BROWN, ERIC EASLEY BROWN, JOSHUA site review KINGSTREE BROWNE, ALISON GREENVILLE BROWNE, NANCY MYRTLE BEACH BROWNLEE, ROBERT WILLIAMSTON BRYAN, BEAU T COLUMBIA BUCKNER, MEREDITH ANDERSON BUEHNER, JACLYN site review MONCKS CORNER BULLARD, KAY S CHERAW BURBRIDGE, MARK T primary ROCK HILL BURGESS, SALLEY site review CLINTON BURNOS, VICTORIA GREER BURNS, JEREMY SPARTANBURG BURROWS, DENNIS FLORENCE BUTEHORN, H FREDERICK III SPARTANBURG BYRD, EDWIN O (b) (6) WOODRUFF BYRD, JIM F JR Top 5/Med Plus site review AIKEN BYRD, SHERI WOODRUFF BYRNE, JENNIFER A GREENVILLE CALCHARY, AMY GREENWOOD CAMPBELL, ALEXIS GREENVILLE CAMPBELL, STACY NORTH CHARLESTON CAMPBELL, ZEKE BEAUFORT CANNON MEMORIAL HOSPITAL PICKENS CANNON PSYCHOLOGICAL ASSOCS CLEMSON CARDIOLOGY CONSULTANTS PA SPARTANBURG CARLTON, PAMELA site review COLUMBIA CAROLINA CARDIAC SURGERY COLUMBIA CAROLINA HEART & VASCULAR C AIKEN CAROLINA HEART SPECIALISTS LANCASTER CAROLINA LUNG AND SLEEP CEN COLUMBIA CAROLINA MED CTR OF WALTER WALTERBORO CAROLINA PINES REG MED CTR HARTSVILLE CAROLINA PULMONARY PHYS site review ROCK HILL CAROLINA RADIOLOGY ASSOCIAT DALLAS CAROLINA VASCULAR INSTITUTE site review GREENWOOD CAROLINAS HOSP SYSTEM MARIO MULLINS CAROLINAS HOSPITAL SYSTEM FLORENCE CARPENTER, RICHARD L JR SANTEE CARTER, DENISE LADYS ISLAND CARTER, RICHARD M GREENWOOD CASSONE, ROCCO D ORANGEBURG CASTELLO, LESLIE SENECA CHURCH, SAMANTHA CHARLESTON CLARK-BROWN, ANNETTE FLORENCE CLARY, MATTHEW T COLUMBIA CLEAVELAND, BONNIE F site review CHARLESTON CLELLAND, CARLSON GREER CLEMSON EYE PA CLEMSON CLEVELAND, AMANDA J site review GREENWOOD COASTAL CAROLINA MEDICAL CT HARDEEVILLE COASTAL VASCULAR & VEIN CEN CHARLESTON COBURN, ASHLEY M SUMMERVILLE COE, MARK STERLYN site review LANCASTER COLEMAN, LAWRENCE R BEAUFORT COLEMAN-LEBBY, VANESSA ORANGEBURG COLLETON MEDICAL CENTER WALTERBORO COLLINS, ROBERT J III WILLIAMSTON COLPITT, PATRICK site review NORTH CHARLESTON CONGDON, GERALD F site review PAWLEYS ISLAND CONWAY HOSP O/P DIAGNOSTIC CONWAY CONWAY HOSPITAL INC (b) (6) CONWAY COPPOLA, PAUL K site review WESTMINSTER CORLEY, VIRGINIA SUMTER COVINGTON, AL H site review CHERAW COX, KEITH S NEWBERRY CRAWFORD, CARRIE ELIZABETH site review GREENVILLE CRAWFORD, KENNON FOUNTAIN INN CRAWFORD, PATRICIA A GREENVILLE CRESS, ROBERT M site review ORANGEBURG CRISWELL, KAREN SAVANNAH CROOK, THEODORE G CAMDEN CRYER, MICHAEL site review COLUMBIA CUNNINGHAM, CALHOUN D SURFSIDE BEACH CUSTER, JOHN V site review CHARLESTON CUTTS, TRAVEA site review ANDERSON DANIELS, DAMON site review COLUMBIA DAS, SUSHIL K site review ROCK HILL DAVIS, KATE L CHARLESTON DAVIS, NORDEN W site review GAFFNEY DAWKINS, PATRISE GREENVILLE DE CHAMPLAIN, RICHARD E GEORGETOWN DEAN, STEVEN SUMTER DEARING, MEGAN NORTH CHARLESTON DEHOLL, J DAVID site review ANDERSON DELGADO, ANTHONY E site review GREENVILLE DEPACE, ALFRED NICHOLAS primary site review LEXINGTON DIVITO, JASON R Top 5/Med Plus GREENWOOD DIXON, MARGO L CHARLESTON DOCTORS HOSPITAL AUGUSTA DRAISIN VISION GROUP CHARLESTON DRAISIN, NEIL CHARLESTON DUKES, JOHNNY R LANCASTER DUNCAN, ERIN PORT ROYAL DYLEWSKI, STEFAN M MYRTLE BEACH EARLY, IRA G JR site review SPARTANBURG EDGEFIELD COUNTY HOSPITAL EDGEFIELD EDWARDS, NATHANIEL G ROCK HILL EDWARDS, NICOLE NEWBERRY EDWARDS, R MALCOLM LANCASTER ELBASH, ABDEL R SUMTER ELLENBURGER, KURT R BEAUFORT ELLYN, JOHN C site review CHARLESTON ENGELBARTS, RACHEL RIDGELAND ESHENRODER, NATHAN top 5/SBS Medical site review GREENVILLE ETIKERENTSE, TEMISAN L site review NORTH CHARLESTON EVANS, REGINA PAWLEYS ISLAND EVANS, VICTORIA P site review (b) (6) ROCK HILL FAIRFIELD MEMORIAL HOSPITAL WINNSBORO FELICIANO, ANNA E COLUMBIA FERVIL, MARIE Y. WALTERBORO FISHBURNE, FRANCIS J MT PLEASANT FLORENCE MRI & IMAGING site review FLORENCE FLOWERS, STEPHEN K SUMTER FLOYD, ALLISON KIMBLE LEXINGTON FLOYD, JOSEPH H JR BEAUFORT FOGLE, VERNELL K COLUMBIA FOLGAR, FRANCISCO A FLORENCE FORD, JEFFERY C COLUMBIA FOSTER, JOHN SPARTANBURG FOULKES-JAMISON, LESLEY site review IRMO FRANK, ADAM FLORENCE FRANKLIN, CRYSTAL L PAWLEYS ISLAND FRANKLIN, ROBERT SPARTANBURG FRIEDMAN, ROBERT ANDERSON FRISHBERG, DEBBIE ORANGEBURG FRITZ, JONATHAN P FORT MILL GABRIEL, MEGAN A CHARLESTON GALLOWAY, JERRY E site review GREENWOOD GALPHIN, ROBERT LEE primary site review COLUMBIA GARDNER, LAURA SUMMERVILLE GARG, AJAY GREENVILLE GARRETT, KEVIN G JR FLORENCE GASKIN, HUGH C III FLORENCE GEORGETOWN COUNTY MEM HOSP GEORGETOWN GIBSON, TODD GREENWOOD GIRI, ANSHU primary site review SUMMERVILLE GLASER, DONALD EASLEY GLENN, GERALDINE WINNSBORO GLENN, KATHRYN FULLER NEWBERRY GOLDSMITH, JOSEPH P ROCK HILL GONZALEZ-ACEVEDO, ALBERT FLORENCE GOODSON, JAMES A III SUMTER GOTTLIEB, DVORA SAVANNAH GOULAS, MARK T site review BLUFFTON GOURLEY, NEESHA site review ROCK HILL GRANTHAM, R LEE site review AIKEN GRAVES, LAURIE ROCK HILL GRAY, REBEKAH NORTH CHARLESTON GRAY, TOMMI FLORENCE GREEN, AMBER S site review ROCK HILL GREENE, HOWARD site review FLORENCE GREENE-NORRIS, ENGLAND (b) (6) FLORENCE GREENVILLE MEMORIAL HOSPITA GREENVILLE GREGG, HARRIETTE ORANGEBURG GRIFFIN, WILLIAM site review KINGSTREE HAGENAUER, ANDREW Top 5/SBS Medical SENECA HAGGERTY, CHRISTOPHER JAY SPARTANBURG HALLER, RAPHAEL ORANGEBURG HAMMOND, ELLIE C site review GREENVILLE HAMMOND, JOSEPH K primary site review SENECA HAMPTON REG MEDICAL CENTER VARNVILLE HANNAH, JESSICA ROCK HILL HARARI, MARC COLUMBIA HARDAWAY, WILLIAM D FLORENCE HARE, ESTER R ORANGEBURG HARPER, EMILY site review GREER HARPER, RENUKA R site review GREENVILLE HARRIS, LUETTA FLORENCE HAUBERT, MATTHEW AIKEN HAWKINS, KAITLIN M AIKEN HAYES, DANYELLE site review SUMTER HAYNES, ANDROMEDA ORANGEBURG HAYNES, CHARLES ORANGEBURG HENRY, BRIAN NELSON DUE WEST HERRIN, TRACEY HILTON HEAD HERROD, NIKKI COLUMBIA HICKLIN, ARLENE GREENWOOD HICKLIN, ELIZABETH GREENVILLE HICKLIN, JONATHAN C FORT MILL HILL, ELIZABETH KAY site review SPARTANBURG HILL, JAMES F III JOHNS ISLAND HILL, LAURIE G SAVANNAH HILLCREST HOSPITAL SIMPSONVILLE HILLIARD, GABBY site review ANDERSON HILTON HEAD REG MED CTR HILTON HEAD HO, KIM THIEN N LANCASTER HOBBS, STEVEN C site review LAKE CITY HOLLAND, EVANS P FLORENCE HOLMES, ESSIE L KINGSTREE HOLT, DAVID N primary SENECA HOPKINS, JOSEPH E site review GREENVILLE HOPKINS, KERRI GREENVILLE HOPKINS, ROSALIE LEE GREENVILLE HOPLA, DAN M site review FLORENCE HUDSON, ASHLEY SUMMERVILLE HUFF, BRIAN COLUMBIA HULL, WILLIAM M JR ROCK HILL HURD, SHAYE S site review NORTH CHARLESTON HURSEY, ARCHIBALD WESLEY JR (b) (6) COLUMBIA HYNES, JOHN DEWEY COLUMBIA ILG, BORIS A ANDERSON IMAGING CENTER (SELF REGION site review GREENWOOD IMAGING SPEC OF CHARLESTON MT PLEASANT INLET CARDIOPULMONARY & ASS MURRELLS INLET INLET PULMONARY CRIT CARE & MURRELLS INLET INNERVISION MRI/IMAGING GRO GREENVILLE ISAYEV, JENNIFER COHEN SAVANNAH ISENHOWER, W DAVID JR ABBEVILLE IWEGBUE, KWAME N MONCKS CORNER JACOBS, DEAN R site review COLUMBIA JACOBUS, DWIGHT A site review EASLEY JAMES, ALEQUE ROCK HILL JAMES, DEBORAH C site review CHERAW JANIT, ADRIAN S AUGUSTA JENKINS, SHARON F ORANGEBURG JENKINS, WILLIAM P WALHALLA JOHNSON, BRIAN EASLEY JOHNSON, DAVID BENNETTSVILLE JOHNSON, EDWARD C site review KINGSTREE JOHNSON, KIMBERLY Z AIKEN JOHNSON, OWEN GEORGETOWN JOHNSON, THOMAS ROCK HILL JOHNSON-BAILEY, MELANIE NEWBERRY JONES, CHRISTOPHER T ROCK HILL JONES, CONIGLIARO COLUMBIA JONES, JUNE BARTELL site review FLORENCE JORDAN, WHITNEY TAPP site review MT PLEASANT JOUDEH, THAER site review GREENVILLE JUNKER, DAVID A Top 5/SCIME site review GREENVILLE JURS, DENNIS G SPARTANBURG KABEALO, KELLE CHARLESTON KANWISHER, MICHAEL A Top 5/Med Plus site review KINGSTREE KARNIBAD, YVETTE COOK SAVANNAH KEENEY, SARA GREENVILLE KEITH, BRIAN A site review ANDERSON KELLY, KIMBERLY SUMTER KELLY, TIMOTHY J ROCK HILL KENDALL, KRISTIN GREENVILLE KENNARD, ERIKA MYRTLE BEACH KERSHAWHEALTH MEDICAL CENTE CAMDEN KILGUS, CHRISTOPHER LEE site review ORANGEBURG KING, GREGORY A FLORENCE KING, SALLY COLUMBIA KITCH, RUSSELL D site review CHARLESTON KMONICEK, JOSEPH M (b) (6) FLORENCE KNOWLES, MELISSA ANDERSON KNOX, KENNETH E SIMPSONVILLE KOFOED, BRUCE primary site review GREENVILLE KOLEHMA, KERRI CHARLESTON KORN, LARY RICHARD Top 5/SCIME site review GREENVILLE KOSER, ANDRAS site review GAFFNEY KOZAK, LAUREN GREER KOZLOWSKI, JEFFREY D AIKEN KRAININ, FRED M FLORENCE KRUSE, KIMBERLY KAYE COLUMBIA KUHL, DANA E WALHALLA KUMAR, SANJAY WALTERBORO KURES, PETER R ROCK HILL KWAKYE, ADONTENG A primary site review BEAUFORT LABARRE, NICHOLAS SUMMERVILLE LAKE CITY COMMUNITY HOSPITA LAKE CITY LANCASTER IMAGING CENTER LANCASTER LANGLEY, SHARON B ORANGEBURG LARRIMORE, BETH SAVANNAH LATTIMORE, CHARLITA SPARTANBURG LAURENS COUNTY HOSPITAL CLINTON LAWRENCE, FELICIA site review ORANGEBURG LEA, LAUREN GREER LEE, JAMES T FLORENCE LEE, JASON C FLORENCE LEKOUBOU LOOTI, ALAIN ZINGR Top 5/Med Plus KINGSTREE LEPOROWSKI, DEBORAH K GREENVILLE LESLIE, KAREN E DUE WEST LEWIS, BRETT WILLIAMSTON LIMA, STEFANIA DE MELOE CLINTON LIMBERT, JAMES G site review BLUFFTON LINK, HENRY W site review FAIRMONT LITTLE, ELIZABETH W HARTSVILLE LIVINGSTON, ROBERT E III site review NEWBERRY LOFTIS, C EARL JR LEESVILLE LOFTON, LATANYA D FLORENCE LOMBARDI, ALYSE CATHERINE LANCASTER LONG BAY DIAGNOSTIC IMAGING site review MYRTLE BEACH LORD, LORI P Top 5/Med Plus site review NEWBERRY LORING, CALEB IV primary site review SPARTANBURG LORIS COMMUNITY HOSPITAL LORIS LOVE, BRITTANY site review SIMPSONVILLE LOWE, PHILLIP D site review FLORENCE LUKE, ROBERT A FLORENCE LUNN, RONALD ORANGEBURG LYNES, MICHELLE (b) (6) SAVANNAH LYTTLE, DEANNA P FLORENCE MAGUIRE, WILLIAM JR CHARLESTON MAHLIE, NANCY CLEMSON MAHON, ROBERT JR GREENVILLE MALKA, JULIE CHARLESTON MANOS, PETER BEAUFORT MARANVILLE, JUNE K site review LEXINGTON MARCUS, ANNA MONCKS CORNER MARI-COLON, JULIA site review GREENVILLE MARION, A DOUGLAS CHESTER MARTIN, JEFFERY S COLUMBIA MARY BLACK HEALTH SYS GAFFN GAFFNEY MARY BLACK MEMORIAL HOSP SPARTANBURG MASINDET, SARBABI CHARLESTON MASON, KRISTIN J ROCK HILL MASON, MONICA site review CHARLESTON MATHIS, CAROL SPARTANBURG MATTISON, EDWARD C ANDERSON MCCLAIN, MARK A CHARLESTON MCCONNELL, KRISTIN SMITH GREER MCCULLOH THERAPEUTIC SOLUTI GREER MCCULLOH, SARAH D SPARTANBURG MCKENZIE, DAVID H JR ESTILL MCLEOD CARDIOLOGY ASSOCIATE FLORENCE MCLEOD HEALTH CHERAW CHERAW MCLEOD HEALTH CLARENDON MANNING MCLEOD MEDICAL CTR - DARLIN DARLINGTON MCLEOD MICU FLORENCE MCLEOD REG MED CTR - DILLON DILLON MCLEOD REG MEDICAL CENTER FLORENCE MCLEOD, ANGELA N COLUMBIA MCMAHON, ALISA site review EASLEY MCMANUS, EUGENE F SPARTANBURG MCMILLAN, NINA MCKENZIE GREER MDSI PHYSICIAN GROUP INC FLORENCE MEHTA, REENA site review WEST COLUMBIA MEMORIAL MEDICAL OFC BLDG GREENVILLE MERHI, EVA site review MYRTLE BEACH MGC MEDICAL AFFILIATES N GR site review SPARTANBURG MIELE, ELLEN EASLEY MIKKELSON, MICHAEL K BLUFFTON MILFORD, WILLIAM site review ANDERSON MILLENDER, CATHERINE MEEKIN primary site review ROCK HILL MILLER, AARON WALTERBORO MILNE, H L COLUMBIA MITCHELL, CARL I (b) (6) COLUMBIA MOBERLY, REBECCA L NORTH AUGUSTA MODESTO, MARIA COLUMBIA MONTGOMERY, SAMUEL JACOB site review NEWBERRY MOODY, ROBIN L site review ANDERSON MOON, DAVID site review JOHNSONVILLE MORPHIS, ELIZABETH HARTSVILLE MORPHIS, JAMES O JR HARTSVILLE MORTON, TODD L GAFFNEY MOTYCKA, THOMAS J primary site review COLUMBIA MOUNTAINVIEW MEDICAL IMAGIN SENECA MOYLAN, WILLIAM J JR site review SUMMERVILLE MUIR, ELIZABETH GREENVILLE MUNSON, HOLLY Top 5/SBS Medical SENECA MYERS, KATHY IRMO NAGEL, TERRY L JR site review LEXINGTON NAPPI, RONALD site review WALTERBORO NASO, NICOLETTE FLORENCE NAVA, MARISA site review CHARLESTON NAZARIO, NILSA I site review LAURENS NELSON, DAVID BRIAN FORT MILL NEWBERRY CNTY MEM HOSPITAL NEWBERRY NEWLAND, THOMAS WALTERBORO NEWMAN, THEODORE W HARTSVILLE NGUYEN, SHAUN A primary site review ORANGEBURG NICHOLS, MEGAN MYRTLE BEACH NORMAN, MATT WEST COLUMBIA NOVANT HEALTH IMAGING ROCK ROCK HILL NUSZ, KEVIN LANCASTER NWAEKWU, IFEANYI MONCKS CORNER OBENG, FRANCIS MONCKS CORNER OCONEE MEMORIAL HOSPITAL SENECA OLIVER, DAVID site review ROCK HILL OLIVER, W C ROCK HILL OM, ANIL FLORENCE OMOTOSO, OMOLOLA A NORTH CHARLESTON ONDERSMA, BENJAMIN COLUMBIA OSENTOSKI, MARIANNE site review HILTON HEAD OSMAN, RICHARD C MYRTLE BEACH PACK, MARK STEPHEN FLORENCE PADGETT, L MICHAEL WALTERBORO PALMETTO BAPTIST PULMONARY COLUMBIA PALMETTO BAPTIST-COLUMBIA COLUMBIA PALMETTO CARDIOLOGY ASSOCS COLUMBIA PALMETTO HEALTH TUOMEY SUMTER PALMETTO IMAGING COLUMBIA PALMETTO IMAGING - IRMO site review (b) (6) IRMO PALMETTO LANGUAGE & SPEECH LEXINGTON PALMETTO PULMONARY & CRITIC GREENVILLE PALMETTO PULMONARY MEDICINE BEAUFORT PALMETTO RICHLAND MEM HOSP COLUMBIA PARISI, JOSEPH L CLEMSON PARKE, CHARLES W K Top 5/SCIME site review GREENVILLE PARKS-SKINNER, BILLIE GREENVILLE PARSONS, GREGORY site review NEWBERRY PATEL, PRANAY R SPARTANBURG PATEL, PRAVIN R Top 5 site review CLIO PATHEJA, NINI S AIKEN PAYNE, MANDY LANCASTER PEE DEE SPEECH-HEARING CTR site review FLORENCE PENNINGTON, AMANDA site review ROCK HILL PETIT, SCOTT J COLUMBIA PEYSER, ROBERT E CHARLESTON PHILLIPS, TABITHA MAULDIN PIEDMONT IMAGING SPARTANBURG PIEDMONT MEDICAL CENTER ROCK HILL PITCAVAGE, JOSEPH GOOSE CREEK POCKL, JEFFREY S SANTEE POLAND, ROBERT M GREENVILLE POLLOCK, KAREN CLINTON POOLE, BENJAMIN C CLOVER PORTER, DAVID ANDERSON POWELL, DENISE CHARLESTON POWERS, THERESA J MONCKS CORNER PRICE, DAVID R site review GREENVILLE PRICE, STACI SENECA PRIMECARE FAMILY PRACTICE GOOSE CREEK PRITCHARD-BOONE, ANDREA LEA FLORENCE PULMONARY DISEASES CARE site review CHARLESTON PURCELL, JERRY S site review ANDERSON QURESHI, FAROOQ site review CHERAW RADEMACHER, JAMES R FLORENCE RAY, TRACY LORIS RAYKOVICZ, LEE JOSEPH ROCK HILL REDDY, BHASKAR R ROCK HILL REED, DOUGLAS J site review ANDERSON REEVES, STEVE L SPARTANBURG REGIONAL MED CTR-O'BURG/CAL ORANGEBURG REIDENBACH, JENNIFER MT PLEASANT RICHARDS, CAROLINE SPARTANBURG RICHARDSON, MELISSA site review GREENVILLE RICHARDSON, SHEANA SAVANNAH RIDDLE, HARVARD K JR (b) (6) NEWBERRY RIDGEWAY, REUBEN B site review ORANGEBURG RIGDON, CHERYL DAVIS GREENVILLE RITTERSPACH, CHAD primary site review WAXHAW RITZ, DOUGLAS R primary site review GEORGETOWN RIVERVIEW MEDICAL CENTER ROCK HILL ROBINSON, INDIA Top 5/SBS Medical site review MYRTLE BEACH ROBINSON, JONATHAN M FORT MILL ROBINSON, LAURIE C CAMDEN RODRIGUEZ-SCOTT, MARIBEL MONCKS CORNER ROGERS, RICHARD L site review FLORENCE ROJUGBOKAN, ADEBOLA site review GOOSE CREEK ROLFSEN, MATTHEW J primary site review ROCK HILL ROLLINS, PAMELA GREER ROMAN, REGINA A CONWAY ROPER HOSPITAL INC CHARLESTON ROSNER, DANIEL L SURFSIDE BEACH ROSS, MARK J FLORENCE ROWLAND, RUSSELL Top 5/SCIME site review SPARTANBURG ROYAL, GAIL M GEORGETOWN ROZIER, HOPE ORANGEBURG RUBANO, BERNADETTE NORTH MYRTLE BEACH RUCKER, CHRISTOPHER SPARTANBURG RUFFING, JAMES N primary site review SPARTANBURG RUSHTON, FRANCIS BEAUFORT RUSSELL, SAM O III JOHNSONVILLE RUST, KEVIN R NEWBERRY SANDERS, ALEXIS Y FLORENCE SANDIFER, HENRI ORANGEBURG SANGER CLINIC ROCK HILL SAUSSER, GENE J KINGSTREE SAVANNAH SPEECH-HEARING CTR SAVANNAH SAYRE, LARRY ANDERSON SBS MEDICAL SERVICES INC Top 5 GREENVILLE SCATES, KYLE site review NEWBERRY SCHACHER, STEPHEN AUGUSTA SCHEELE, LARRY M SUMTER SCHERL, STEFANI M NORTH CHARLESTON SCHLUETER, ERIC M Top 5/Med Plus COLUMBIA SCHWAN, CAROL AIKEN SCOTT, ERICA MT PLEASANT SCOTT, TODD A site review LANCASTER SEEHORN, SARAH GREENWOOD SELF REGIONAL HEALTHCARE GREENWOOD SELTZER, SAMUEL FLORENCE SETTY, RAJ (b) (6) ANDERSON SEXTON, LAURA SPARTANBURG SHADWICK, KELLY LANCASTER SHAH, JUGALKISHOR K ROCK HILL SHAPIRO, STEVEN D CHARLESTON SHARAF, IDRIS M AIKEN SHAW, SHANITA DAWN ORANGEBURG SHERROD, FAITH site review WALTERBORO SHOOK, DAVID T Top 5/SBS Medical NORTH AUGUSTA SHROUDER, JAMES III Top 5/SBS Medical GREENVILLE SIEGEL, JEFFREY A GREENVILLE SIMON, DANIEL J ROCK HILL SIMONS, JONATHAN ALAN SURFSIDE BEACH SINGH, PRADEEP ROCK HILL SINGHI, SUSHIL K ROCK HILL SINGLETARY, GALE ORANGEBURG SINGLETON, MONNIEQUE site review ORANGEBURG SLOAN, JEFFREY C ROCK HILL SMITH, ALLISON Top 5/Med Plus site review KINGSTREE SMITH, CANDI MYRTLE BEACH SMITH, DANIEL J AIKEN SMITH, LASHONDA Y site review WALTERBORO SMITH, LEILONI N SPARTANBURG SMITH, STEPHEN BROOKS Top 5/SBS Medical site review CLINTON SNOAD, NICOLE GREER SORROW, REBECCA LACEY site review ANDERSON SOUTHERN THERAPY SERVICES CHERAW SPARTANBURG REG OUTPATIENT SPARTANBURG SPITZ, A H ANDERSON SPIVEY, CASHTON B Top 5 site review CHARLESTON SPOKANE, ARNOLD R site review AIKEN SPONSELLER, TRACIE site review AIKEN SPRINGS MEMORIAL HOSPITAL LANCASTER ST FRANCIS HOSPITAL INC GREENVILLE ST PETER, ASHLEIGH J GREENVILLE STANLEY, TOMMI site review NORTH MYRTLE BEACH STEINIGER, ERIK DAVID SPARTANBURG STEPHENSON, DANA M MYRTLE BEACH STEVENS, ALEXANDRA D AIKEN STEVENS, SEAN SPARTANBURG STEWART, JOHN R GREER STOKES, HUNTER R JR FLORENCE STOKES, J HOWARD JR FLORENCE STOKES, MARK site review SUMTER STOOKSBERRY, TIMOTHY Top 5/Med Plus site review KINGSTREE STORY, FRANCES L LANCASTER STOUGHTON, THOMAS FLORENCE STRINI, CAROLYN (b) (6) NORTH CHARLESTON STURGES, AMBER WALTERBORO SUMTER EYE CENTER site review SUMTER SURGICAL ASSOCS OF MYRTLE B MYRTLE BEACH SWITAK, JENNIFER BLUFFTON SZYPCZAK, ROBERT BLUFFTON TALLMAN, BETHANY GREER TARASIDIS, GREGORY ABBEVILLE TAYLOR, CHERILYN YVETTE ORANGEBURG TAYLOR, DENTRESA A VARNVILLE TAYLOR, DOREEN FLORENCE TAYLOR, JOHN M COLUMBIA THE EYE & LASER CENTER site review LANCASTER THODI-PETROU, CHRYSSOULA ORANGEBURG THOMAS, GILL P CLINTON THOMAS, SIDNEY F ORANGEBURG THOMPSON, ALLAN EASLEY THOMPSON, RONALD O primary site review CLINTON THOMPSON, SARAH site review SPARTANBURG TILLER, GERALD R GEORGETOWN TLHABANO, L BENNY ROCK HILL TLM MEDICAL SERVICES LLC COLUMBIA TOLLISON, C DAVID site review GREENVILLE TOMARCHIO, JOHN B Top 5/Med Plus site review NEWBERRY TONKIN, KARIN COLUMBIA TORRES, SHANNON SUMMERVILLE TRACY, MICHELLE ANDERSON TRAVERS, ANGIE SUMMERVILLE TRI COUNTY RADIOLOGY CHARLESTON TRI COUNTY RADIOLOGY ASSOCS NORTH CHARLESTON TRI COUNTY RADIOLOGY ASSOCS MONCKS CORNER TRIBBLE, DAVID E COLUMBIA TRIBBLE, REID W COLUMBIA TRIDENT MED CTR-MONCKS CORN MONCKS CORNER TRIMMIER, HAL BENNETTSVILLE TROTTIER, HILARY SAVANNAH TSAI, MICHELLE WILLIAMSTON TUCKER, HOWARD W JR HARTSVILLE TUCKER, TOM GREENVILLE TURNER, M KEVIN AUGUSTA UCCARDI, AMANDA SAVANNAH UNION MEDICAL CENTER UNION VAN DECAR, LAUREN M Top 5/SBS Medical site review MYRTLE BEACH VANDEGRIFT, RACHEL A SUMMERVILLE VASUKI, VIVEK P site review FLORENCE VEJNAR, MEREDITH BERGEY Top 5/SBS Medical ANDERSON VINING, SETH (b) (6) MT PLEASANT VITKO, CARRIE FLORENCE WACCAMAW COMMUNITY HOSPITAL MURRELLS INLET WADE, JANICE ORANGEBURG WALCK, J HARTSVILLE WARD, TANYA G site review HAMLET WATERS, ROBERT C GREENVILLE WAY, JAMES H primary site review ORANGEBURG WEAVER, DAVID GREENVILLE WELDON, ALLAN M COLUMBIA WENTZEL, SUSAN M FLORENCE WHITE, KRISTIN FLORENCE WHITLEY, JOHN C III Top 5 site review GREENWOOD WHITSON, SALLY H MS ABBEVILLE WIGAND, JASON PAUL COLUMBIA WILLIAMS, JAMIE BAMBERG WILSON, GWENDOLYN D ORANGEBURG WILSON, ROBIN A GREENWOOD WINDSOROVA, DORA site review FLORENCE WISE, FARAH site review BEAUFORT WOOD, ARTHUR GREENVILLE WOOD, LAURENCE W JR FLORENCE WRIGHT, JAMES A COLUMBIA WYLIE, ALLEN FLORENCE YALLAPRAGADA, RATHNA K ORANGEBURG YENSAN, JANICE LEXINGTON YOUNG, CAROLE M GEORGETOWN ZAKHOUR, ISAM J FLORENCE ZERDEN, STEPHANIE SAVANNAH ZOLLINGER, ELIZABETH SAVANNAH ZOLMAN, JENNIFER SMITH CHARLESTON South Dakota FY 2017

Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen (b) (6) John Vidoloff, M.D. Aberdeen Avera St. Luke's - RT 3 0 $ 323.67 Aberdeen Avera St. Luke's - Speech Therapy 2 6 $ 274.10 Aberdeen Pat Couglin, M.S. Aberdeen Steven Redmond, M.D. 18 10 2 $ 4,467.59 Aberdeen Avera St Luke's Peds PT Aberdeen Marshall Dorsett. O.D Aberdeen Francine Sippel, Ed.D. 4 3 1 $ 1,489.46 Aberdeen Edward D'Souza, M.D. Aberdeen Avera St. Luke's - Radiology Aberdeen Lutheran Social Services 2 9 $ 1,467.57 Aberdeen CE Provider Services Aberdeen Sanford Aberdeen Med Ctr Aberdeen KLM Medical Svs - Aberdeen 24 16 3 $ 8,283.65 Aberdeen Dakota Counseling Group 13 6 1 $ 4,611.00 Bismarck Med Center One Bismarck UND Center for Family Medicine Bismarck Link Psychological Svs Bismarck Krista Heil, O.D. Brookings Merritt Warren, M.D. 3 27 $ 936.39 Brookings Yorkshire Eye Clinic 3 8 1 $ 492.93 Brookings Thomas Shaffer, Ph.D. Brookings Avera Brookings Medical Clinic Chamberlain John Jones, M.D. 2 32 $ 309.02 Chamberlain Karen Wiemers, Ph.D. 1 14 3 $ 496.32 Chamberlain Audiology Associates 1 1 $ 68.46 Chamberlain CE Provider Svs - Chamberlain Chamberlain Sanford Chamberlain Clinic Chamberlain Alexander Permann, O.D. 2 53 $ 286.56 Eagle Butte Lynn Goehring, M.A, 9 10 2 $ 8,594.96 Freeman Kenneth Kirton, M.D. 2 18 $ 165.95 Gregory Gregory HealthCare Center-Hospital Gregory Avera Gregory Med Clinic 5 12 $ 1,600.56 Hot Springs (b) (6) Daniel Hafner, M.D. Huron Frank Dame, Ph.D. 2 13 2 $ 720.00 Huron Community Counseling Svs 4 30 1 $ 1,861.20 Huron Huron Regional Med Ctr Huron Gregory Wiedel, M.D. Huron CE Provider Services - Huron Huron KLM Medical Svs - Huron 24 17 5 $ 7,899.90 Lake Andes Richard Honke, II, M.D. 1 8 1 $ 283.54 Lemmon Shirley Herbel, Ph.D. Madison Bernard Heilman, M.D. 2 4 1 $ 199.58 Madison Richard Sample, M.D. Madison Madison Community Hospital - X-ray Madison Community Counseling Svs Miller Audiology Assoc - Miller Mission Maryann Coupland, Ph.D. 13 7 6 $ 8,375.40 Mitchell David Malters, M.D. Mitchell Avera Queen of Peace - RT 1 0 $ 160.75 Mitchell Hearing Plus Mitchell Avera Queen of Peace - Dr. Cho Mitchell Avera Queen of Peace - Speech Mitchell Matthew Christiansen, Ph.D. 3 19 3 $ 1,240.80 Mitchell Children's Care Hospital & School - OT/PT Mitchell Jorge Sanchez, M.D. Mitchell Mabee Eye Clinic Mitchell Dakota Physical Therapy 1 Mitchell Galen Van Kley, Ph.D. 12 34 2 $ 7,830.66 Mobridge Mobridge Regional Hospital 2 Parkston Richard Honke, II, M.D. 2 7 1 $ 661.51 Parkston Jason Wickersham, M.D. 3 10 $ 694.41 Parkston Antoinette Vanderpol, M.D. 2 17 1 $ 567.08 Parkston Christopher Boschee, D.O. Parkston Larissa Sanger, M.D. 4 17 1 $ 1,240.71 Pierre Stephen Stout, M.D. Pierre Lynn Goehring, M.A. 14 10 3 $ 8,896.68 Pierre (b) (6) Capital Area Counseling Svs Pierre St. Mary's Hospital - RT Pierre Audiology Assoc Pierre St. Mary's Hospital - Speech 1 1 3 $ 121.86 Pierre St. Mary's Hospital - OT Pierre St. Mary's Hospital - X-ray Pierre Jodi Owen, Psy.D. 1 13 $ 479.84 Pine Ridge Marv Bouska, M.S. 2 Pine Ridge Greg Swenson, Ph.D. - OLC PR College Ctr Pine Ridge Greg Swenson, Ph.D. Rapid City Daniel Hafner, M.D. 5 15 2 $ 804.52 Rapid City Steven Hata, M.D. Rapid City Robert Nixon, M.D. Rapid City Richard Renka, M.D. 1 2 $ 232.12 Rapid City J. Geoffrey Slingsby, M.D. Rapid City Willis Sutliff, M.D. Rapid City Alvin Wessel, M.D. 5 23 1 $ 1,882.25 Rapid City Greg Swenson, Ph.D. 25 5 8$ 12,376.98 Rapid City Rapid City Regional Hospital - RT 13 3 2 $ 1,648.30 Rapid City Mountain Plans Audiology Assoc 1 2 $ 68.46 Rapid City Scott Cherry, Ph.D. Rapid City Black Hills Rehab Hospital Rapid City Craig Mills, M.D. Rapid City Mark Perrenoud, Ph.D. Rapid City Marv Bouska, M.S. 5 9 2 $ 2,481.60 Rapid City Jackie Gilbertson, Ed.D. 23 6 8$ 12,775.74 Rapid City Lifescape - Motor Skills Rapid City Lifescape - Speech 6 9 4 $ 822.30 Rapid City Black Hills Rehab Hospital 1 14 1 $ 137.05 Rapid City Dewey Ertz, Ed.D. 12 9 2 $ 2,946.90 Rapid City David R. Johnson, M.D. Rapid City Paul Zimmerman, M.D. Rapid City Christina Cote, D.O. Rapid City Monte Dirks, M.D. Rapid City (b) (6)Dakota Radiology 76 4 16$ 6,151.40 Rapid City William Moss, Psy.D. Rapid City Rolf Norlin, M.D. 56 12 12$ 15,327.62 Rapid City Donald Blower, M.D. Rapid City Brett Valette, Ph.D. 28 11 8$ 15,121.56 Rapid City Stuart Krause, Ph.D. 9 9 6 $ 4,589.46 Rapid City John Lassegard, M.D. 60 6 10$ 16,982.16 Rapid City Black Hills Psychology 16 14 $ 9,515.34 Rapid City Scott Scrriber, O.D. 1 Rapid City Regional Rehab Institute 1 Sioux Falls Paul Cink, M.D. 3 37 $ 509.24 Sioux Falls Leonard Gutnik, M.D. Sioux Falls Michael McGrath, Ph.D. 10 35 4 $ 9,196.18 Sioux Falls Avera McKennan Hospital - RT 5 12 $ 643.32 Sioux Falls Sanford USD Medical Ctr - RT 5 12 1 $ 732.74 Sioux Falls Center for Family Medicine 29 9 4 $ 8,233.83 Sioux Falls Susan Assam, M.D. Sioux Falls Kelcey Cushman, Aud Sioux Falls Sanford Rehab Speech 2 11 $ 200.10 Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 4 6 1 $ 548.20 Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-Radiology Sioux Falls Stanford Hearing 1 3 1 $ 102.49 Sioux Falls Thomas Price, Ph.D. 44 7 18$ 23,141.42 Sioux Falls Brian Kidman, M.D. 43 11 8$ 14,600.21 Sioux Falls Tracy Stephens, Ph.D. Sioux Falls Tom Styz, M.D. Sioux Falls Jorge Sanchez, M.D. Sioux Falls Rebecca Watson-Miller, Ph.D. 23 1 14$ 5,818.77 Sioux Falls Galen Van Kley, Ph.D. 9 56 2 $ 5,025.24 Sioux Falls Martha Socolofsky, M.D. Sioux Falls Andrea McCann, O.D. Sioux Falls Ophthalmology Ltd Sioux Falls Emily Blegen, Psy.D. 20 5 4$ 10,794.96 Sioux Falls (b) (6) Sioux Falls Family Vision Sioux Falls Kayla Norenberg, M.D. 12 9 6 $ 3,974.04 Sioux Falls Nicholas Venosdel, M.D. 17 9 8 $ 5,831.02 Sisseton Coteau Des Prairies Hospital Spearfish Mountain Plans Audiology Assoc Spearfish Richard Keim, M.D. Spearfish Black Hills Psychology 3 Vermillion Thomas Olson, M.D. Vermillion Robert Packard, Ph.D. 9 11 $ 2,729.76 Vermillion Dan Reiffenberger, M.D. 6 5 $ 1,575.31 Vermillion Galen Van Kley, Ph.D. 4 32 2 $ 2,605.68 Vermillion Michael Moran, M.D. 2 4 $ 374.74 Vermillion Sanford Vermillion Hospital Watertown Prairie Lakes Health Care 2 0 2 $ 149.46 Watertown Robert Packard, Ph.D. 4 Watertown Dan Reiffenberger, M.D. 1 Watertown Professional Hearing Svs 1 1 $ 48.83 Watertown Michael Moran, M.D. 1 Watertown Prairie Lakes Hospital - X-Ray Watertown Robert Buri, Ph.D. 8 14 3 $ 5,893.80 Watertown Jorge Sanchez, M.D. Watertown CE Provider Services - Watertown Webster Elizabeth Gravley, M.D. Winner Winner Regional Health Care Ctr Winner Winner Regional Hospital - Radiology Winner Audiology Assoc Winner Avera Winner Medical Clinic 8 15 $ 2,010.95 Winner Winner Regional Clinic Yankton Yankton Medical Clinic 2 1 $ 257.88 Yankton Todd Farnham, Aud, CCC-A 1 3 $ 37.56 Yankton Lewis & Clark Behavioral Health 5 20 2 $ 1,768.14 Yankton Sacred Heart Hospital - X-ray Yankton Galen Van Kley, Ph.D. 10 37 1 $ 6,204.00 Yankton Psychological Assoc of Yankton 2 30 2 $ 1,147.74 TOTALS 821 11 224$ 293,121.57 Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen John Vidoloff, M.D. Aberdeen (b) (6) Avera St. Luke's - RT 1 2 $ 128.94 Aberdeen Avera St. Luke's - Speech Therapy 1 3 $ 137.05 Aberdeen Pat Couglin, M.S. Aberdeen Steven Redmond, M.D. 3 9 1 $ 824.02 Aberdeen Avera St Luke's Peds PT Aberdeen Marshall Dorsett. O.D Aberdeen Francine Sippel, Ed.D. 1 2 1 $ 372.24 Aberdeen Edward D'Souza, M.D. Aberdeen Avera St. Luke's - Radiology Aberdeen Lutheran Social Services 8 16 2 $ 4,319.64 Aberdeen CE Provider Services Aberdeen Sanford Aberdeen Med Ctr Aberdeen KLM Medical Svs - Aberdeen 20 15 5 $ 6,895.94 Aberdeen Dakota Counseling Group 12 7 1 $ 4,234.00 Bismarck Med Center One Bismarck UND Center for Family Medicine Bismarck Link Psychological Svs Bismarck Krista Heil, O.D. Brookings Merritt Warren, M.D. 2 18 $ 414.81 Brookings Yorkshire Eye Clinic 7 11 $ 1,124.22 Brookings Thomas Shaffer, Ph.D. Brookings Avera Brookings Medical Clinic Chamberlain John Jones, M.D. 3 35 $ 345.21 Chamberlain Karen Wiemers, Ph.D. 2 21 1 $ 1,302.84 Chamberlain Audiology Associates Chamberlain CE Provider Svs - Chamberlain Chamberlain Sanford Chamberlain Clinic Chamberlain Alexander Permann, O.D. 1 Eagle Butte Lynn Goehring, M.A, 17 9 4 $ 16,254.48 Freeman Kenneth Kirton, M.D. 3 20 1 $ 912.67 Gregory Gregory HealthCare Center-Hospital Gregory Avera Gregory Med Clinic 8 20 $ 2,241.97 Hot Springs Daniel Hafner, M.D. Huron Frank Dame, Ph.D. 4 18 1 $ 1,352.00 Huron Community Counseling Svs 3 23 1 $ 1,488.96 Huron Huron Regional Med Ctr Huron (b) (6) Gregory Wiedel, M.D. 4 19 1 $ 1,362.79 Huron CE Provider Services - Huron Huron KLM Medical Svs - Huron 18 25 10 $ 5,478.02 Lake Andes Richard Honke, II, M.D. 4 18 $ 1,134.16 Lemmon Shirley Herbel, Ph.D. Madison Bernard Heilman, M.D. 2 14 2 $ 199.58 Madison Richard Sample, M.D. Madison Madison Community Hospital - X-ray Madison Community Counseling Svs Miller Audiology Assoc - Miller Mission Maryann Coupland, Ph.D. 22 8 3 $ 13,555.74 Mitchell David Malters, M.D. Mitchell Avera Queen of Peace - RT 4 1 2 $ 677.83 Mitchell Hearing Plus Mitchell Avera Queen of Peace - Dr. Cho Mitchell Avera Queen of Peace - Speech Mitchell Matthew Christiansen, Ph.D. 7 15 2 $ 2,140.38 Mitchell Children's Care Hospital & School - OT/PT Mitchell Jorge Sanchez, M.D. Mitchell Mabee Eye Clinic Mitchell Dakota Physical Therapy Mitchell Galen Van Kley, Ph.D. 17 45 1 $ 11,601.48 Mobridge Mobridge Regional Hospital 2 4 $ 374.65 Parkston Richard Honke, II, M.D. 4 9 1 $ 1,143.14 Parkston Jason Wickersham, M.D. 4 11 1 $ 1,668.77 Parkston Antoinette Vanderpol, M.D. 4 15 $ 1,395.81 Parkston Christopher Boschee, D.O. Parkston Larissa Sanger, M.D. 7 15 $ 2,665.33 Pierre Stephen Stout, M.D. Pierre Lynn Goehring, M.A. 16 9 8 $ 10,174.56 Pierre Capital Area Counseling Svs Pierre St. Mary's Hospital - RT 1 1 3 $ 96.97 Pierre Audiology Assoc Pierre St. Mary's Hospital - Speech 2 2 1 $ 243.72 Pierre St. Mary's Hospital - OT 1 43 $ 35.18 Pierre St. Mary's Hospital - X-ray Pierre (b) (6) Jodi Owen, Psy.D. Pine Ridge Marv Bouska, M.S. 13 6 1 $ 2,978.00 Pine Ridge Greg Swenson, Ph.D. - OLC PR College Ctr Pine Ridge Greg Swenson, Ph.D. Rapid City Daniel Hafner, M.D. 7 10 $ 1,209.80 Rapid City Steven Hata, M.D. Rapid City Robert Nixon, M.D. Rapid City Richard Renka, M.D. Rapid City J. Geoffrey Slingsby, M.D. Rapid City Willis Sutliff, M.D. Rapid City Alvin Wessel, M.D. Rapid City Greg Swenson, Ph.D. 13 4 5 $ 6,483.18 Rapid City Rapid City Regional Hospital - RT 11 2 8 $ 1,137.29 Rapid City Mountain Plans Audiology Assoc 2 6 $ 223.53 Rapid City Scott Cherry, Ph.D. Rapid City Black Hills Rehab Hospital Rapid City Craig Mills, M.D. Rapid City Mark Perrenoud, Ph.D. Rapid City Marv Bouska, M.S. 11 6 2 $ 6,141.96 Rapid City Jackie Gilbertson, Ed.D. 24 6 8 $ 12,955.68 Rapid City Lifescape - Motor Skills Rapid City Lifescape - Speech 8 7 2 $ 1,096.40 Rapid City Black Hills Rehab Hospital Rapid City Dewey Ertz, Ed.D. 4 8 1 $ 1,178.76 Rapid City David R. Johnson, M.D. Rapid City Paul Zimmerman, M.D. Rapid City Christina Cote, D.O. Rapid City Monte Dirks, M.D. Rapid City Dakota Radiology 79 2 10 $ 6,688.34 Rapid City William Moss, Psy.D. Rapid City Rolf Norlin, M.D. 59 17 5 $ 14,693.46 Rapid City Donald Blower, M.D. Rapid City Brett Valette, Ph.D. 37 7 8 $ 19,326.08 Rapid City Stuart Krause, Ph.D. 15 6 6 $ 7,251.58 Rapid City John Lassegard, M.D. 60 6 11$ 17,010.24 Rapid City Black Hills Psychology Rapid City Scott Scrriber, O.D. Rapid City (b) (6) Regional Rehab Institute Sioux Falls Paul Cink, M.D. 2 9 $ 247.94 Sioux Falls Leonard Gutnik, M.D. Sioux Falls Michael McGrath, Ph.D. 13 49 1 $ 11,771.82 Sioux Falls Avera McKennan Hospital - RT 2 11 $ 297.73 Sioux Falls Sanford USD Medical Ctr - RT 5 6 $ 329.87 Sioux Falls Center for Family Medicine 40 15 6 $ 7,356.53 Sioux Falls Susan Assam, M.D. 1 5 $ 283.54 Sioux Falls Kelcey Cushman, Aud Sioux Falls Sanford Rehab Speech Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 5 5 1 $ 685.25 Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-Radiology Sioux Falls Stanford Hearing 4 Sioux Falls Thomas Price, Ph.D. 33 7 8 $ 16,564.68 Sioux Falls Brian Kidman, M.D. 32 11 2 $ 11,946.41 Sioux Falls Tracy Stephens, Ph.D. Sioux Falls Tom Styz, M.D. Sioux Falls Jorge Sanchez, M.D. Sioux Falls Rebecca Watson-Miller, Ph.D. 6 1 11 $ 1,489.83 Sioux Falls Galen Van Kley, Ph.D. 12 43 2 $ 6,762.36 Sioux Falls Martha Socolofsky, M.D. Sioux Falls Andrea McCann, O.D. Sioux Falls Ophthalmology Ltd Sioux Falls Emily Blegen, Psy.D. 14 6 3 $ 7,320.72 Sioux Falls Sioux Falls Family Vision Sioux Falls Kayla Norenberg, M.D. 1 Sioux Falls Nicholas Venosdel, M.D. 27 13 9 $ 8,998.13 Sioux Falls Avera Mckennan Hospital - Audiology 1 Sioux Falls Avera Audiology Clinic 1 9 $ 142.39 Sioux Falls Vitality Psychological Svs 9 8 $ 5,676.66 Sisseton Coteau Des Prairies Hospital Spearfish Mountain Plans Audiology Assoc Spearfish Richard Keim, M.D. Spearfish Black Hills Psychology 14 24 4 $ 8,612.32 Vermillion Thomas Olson, M.D. Vermillion Robert Packard, Ph.D. 10 17 $ 2,760.78 Vermillion (b) (6) Dan Reiffenberger, M.D. 6 6 $ 1,805.77 Vermillion Galen Van Kley, Ph.D. 7 37 2 $ 4,404.84 Vermillion Michael Moran, M.D. 1 1 $ 187.37 Vermillion Sanford Vermillion Hospital Watertown Prairie Lakes Health Care 1 1 $ 138.51 Watertown Robert Packard, Ph.D. 4 Watertown Dan Reiffenberger, M.D. Watertown Professional Hearing Svs Watertown Michael Moran, M.D. 1 Watertown Prairie Lakes Hospital - X-Ray Watertown Robert Buri, Ph.D. 1 14 $ 558.36 Watertown Jorge Sanchez, M.D. Watertown CE Provider Services - Watertown Watertown Lee Hendricks, Psy.D. 12 14 4 $ 7,879.08 Webster Elizabeth Gravley, M.D. Winner Winner Regional Health Care Ctr Winner Winner Regional Hospital - Radiology Winner Audiology Assoc 1 2 68.46 Winner Avera Winner Medical Clinic 3 24 1 $ 116.47 Winner Winner Regional Clinic Yankton Yankton Medical Clinic 2 4 2 $ 154.72 Yankton Todd Farnham, Aud, CCC-A Yankton Lewis & Clark Behavioral Health 5 29 1 $ 1,861.20 Yankton Sacred Heart Hospital - X-ray 1 8 $ 197.17 Yankton Galen Van Kley, Ph.D. 18 45 4 $ 11,093.12 Yankton Psychological Assoc of Yankton 1 8 $ 744.48

TOTALS 842 13 190$ 315,127.91 Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total Aberdeen (b) (6) John Vidoloff, M.D. Aberdeen Avera St. Luke's - RT 1 1 $ 128.94 Aberdeen Avera St. Luke's - Speech Therapy 1 1 2 $ 137.05 Aberdeen Pat Couglin, M.S. Aberdeen Steven Redmond, M.D. 16 15 1 $ 4,781.54 Aberdeen Avera St Luke's Peds PT Aberdeen Marshall Dorsett. O.D 2 14 $ 533.57 Aberdeen Francine Sippel, Ed.D. Aberdeen Edward D'Souza, M.D. Aberdeen Avera St. Luke's - Radiology Aberdeen Lutheran Social Services 2 29 $ 1,329.12 Aberdeen CE Provider Services Aberdeen Sanford Aberdeen Med Ctr Aberdeen KLM Medical Svs - Aberdeen 11 15 2 $ 4,338.57 Aberdeen Dakota Counseling Group 8 6 4 $ 2,813.00 Bismarck Med Center One Bismarck UND Center for Family Medicine Bismarck Link Psychological Svs Bismarck Krista Heil, O.D. Brookings Merritt Warren, M.D. 2 17 $ 614.08 Brookings Yorkshire Eye Clinic 5 18 $ 693.10 Brookings Thomas Shaffer, Ph.D. Brookings Avera Brookings Medical Clinic Chamberlain John Jones, M.D. 4 33 $ 409.40 Chamberlain Karen Wiemers, Ph.D. 4 21 1 $ 2,667.72 Chamberlain Audiology Associates Chamberlain CE Provider Svs - Chamberlain Chamberlain Sanford Chamberlain Clinic Chamberlain Alexander Permann, O.D. 4 14 $ 841.67 Eagle Butte Lynn Goehring, M.A, 14 8 2 $ 12,904.32 Freeman Kenneth Kirton, M.D. 3 17 2 $ 1,155.34 Gregory Gregory HealthCare Center-Hospital Gregory Avera Gregory Med Clinic 3 60 $ 686.62 Hot Springs Daniel Hafner, M.D. Huron Frank Dame, Ph.D. 1 Huron Community Counseling Svs 3 23 2 $ 1,706.70 Huron Huron Regional Med Ctr 1 1 2 $ 135.43 Huron Gregory Wiedel, M.D. 1 23 $ 283.54 Huron CE Provider Services - Huron Huron KLM Medical Svs - Huron 23 19 5 $ 8,415.94 Lake Andes (b) (6) Richard Honke, II, M.D. 2 12 $ 567.08 Lemmon Shirley Herbel, Ph.D. Madison Bernard Heilman, M.D. 2 38 $ 249.58 Madison Richard Sample, M.D. Madison Madison Community Hospital - X-ray Madison Community Counseling Svs Miller Audiology Assoc - Miller Mission Maryann Coupland, Ph.D. 24 13 5 $ 14,561.40 Mitchell David Malters, M.D. Mitchell Avera Queen of Peace - RT 1 Mitchell Hearing Plus 2 9 $ 410.57 Mitchell Avera Queen of Peace - Dr. Cho Mitchell Avera Queen of Peace - Speech Mitchell Matthew Christiansen, Ph.D. 1 29 2 $ 744.48 Mitchell Children's Care Hospital & School - OT/PT Mitchell Jorge Sanchez, M.D. Mitchell Mabee Eye Clinic Mitchell Dakota Physical Therapy 1 9 $ 137.05 Mitchell Galen Van Kley, Ph.D. 12 33 2 $ 7,568.88 Mobridge Mobridge Regional Hospital Parkston Richard Honke, II, M.D. 1 7 3 $ 283.54 Parkston Jason Wickersham, M.D. 1 19 1 $ 352.13 Parkston Antoinette Vanderpol, M.D. 2 6 1 $ 613.37 Parkston Christopher Boschee, D.O. Parkston Larissa Sanger, M.D. 6 17 $ 2,071.97 Pierre Stephen Stout, M.D. Pierre Lynn Goehring, M.A. 6 8 3 $ 4,094.64 Pierre Capital Area Counseling Svs Pierre St. Mary's Hospital - RT Pierre Audiology Assoc Pierre St. Mary's Hospital - Speech 2 4 $ 243.72 Pierre St. Mary's Hospital - OT Pierre St. Mary's Hospital - X-ray Pierre Jodi Owen, Psy.D. Pine Ridge Marv Bouska, M.S. 10 20 1 $ 5,664.62 Pine Ridge Greg Swenson, Ph.D. - OLC PR College Ctr Pine Ridge Greg Swenson, Ph.D. Rapid City Daniel Hafner, M.D. 10 10 2 $ 1,961.19 Rapid City Steven Hata, M.D. Rapid City Robert Nixon, M.D. Rapid City Richard Renka, M.D. Rapid City (b) (6) J. Geoffrey Slingsby, M.D. Rapid City Willis Sutliff, M.D. Rapid City Alvin Wessel, M.D. Rapid City Greg Swenson, Ph.D. 18 6 5 $ 9,771.30 Rapid City Rapid City Regional Hospital - RT 4 2 1 $ 658.88 Rapid City Mountain Plans Audiology Assoc 4 4 2 $ 305.39 Rapid City Scott Cherry, Ph.D. Rapid City Black Hills Rehab Hospital Rapid City Craig Mills, M.D. Rapid City Mark Perrenoud, Ph.D. Rapid City Marv Bouska, M.S. 8 6 6 $ 4,628.92 Rapid City Jackie Gilbertson, Ed.D. 24 7 3 $ 14,094.80 Rapid City Lifescape - Motor Skills 1 7 $ 137.05 Rapid City Lifescape - Speech 6 20 7 $ 822.30 Rapid City Black Hills Rehab Hospital Rapid City Dewey Ertz, Ed.D. 4 9 $ 744.48 Rapid City David R. Johnson, M.D. Rapid City Paul Zimmerman, M.D. Rapid City Christina Cote, D.O. Rapid City Monte Dirks, M.D. Rapid City Dakota Radiology 77 2 12 $ 7,962.43 Rapid City William Moss, Psy.D. Rapid City Rolf Norlin, M.D. 50 13 6 $ 12,925.76 Rapid City Donald Blower, M.D. Rapid City Brett Valette, Ph.D. 24 5 5 Rapid City Stuart Krause, Ph.D. 5 7 4 $ 2,549.70 Rapid City John Lassegard, M.D. 63 5 8 $ 17,863.02 Rapid City Black Hills Psychology 12 25 $ 7,252.48 Rapid City Scott Scrriber, O.D. Rapid City Regional Rehab Institute 1 Sioux Falls Paul Cink, M.D. Sioux Falls Leonard Gutnik, M.D. Sioux Falls Michael McGrath, Ph.D. 9 51 6 $ 6,949.72 Sioux Falls Avera McKennan Hospital - RT 1 20 $ 133.18 Sioux Falls Sanford USD Medical Ctr - RT 3 3 1 $ 379.14 Sioux Falls Center for Family Medicine 30 16 2 $ 5,617.08 Sioux Falls Susan Assam, M.D. Sioux Falls Kelcey Cushman, Aud Sioux Falls Sanford Rehab Speech 1 10 1 $ 67.30 Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) 4 7 $ 548.20 Sioux Falls CCHS Rehabilitation Ctr 1 2 $ 82.51 Sioux Falls (b) (6) Sanford-Radiology Sioux Falls Stanford Hearing 4 13 $ 409.96 Sioux Falls Thomas Price, Ph.D. 17 2 $ 7,630.92 Sioux Falls Brian Kidman, M.D. 21 10 4 $ 8,264.42 Sioux Falls Tracy Stephens, Ph.D. Sioux Falls Tom Styz, M.D. Sioux Falls Jorge Sanchez, M.D. Sioux Falls Rebecca Watson-Miller, Ph.D. 6 1 9 $ 1,433.61 Sioux Falls Galen Van Kley, Ph.D. 7 40 2 $ 3,536.28 Sioux Falls Martha Socolofsky, M.D. Sioux Falls Andrea McCann, O.D. Sioux Falls Ophthalmology Ltd Sioux Falls Emily Blegen, Psy.D. 6 1 1 $ 3,722.40 Sioux Falls Sioux Falls Family Vision Sioux Falls Kayla Norenberg, M.D. Sioux Falls Nicholas Venosdel, M.D. 14 18 5 $ 5,071.74 Sioux Falls Avera Mckennan Hospital - Audiology Sioux Falls Avera Audiology Clinic Sioux Falls Vitality Psychological Svs 15 10 4 $ 8,747.64 Sioux Falls Midwest Ear, Nose & Throat 1 23 $ 159.83 Sisseton Coteau Des Prairies Hospital Spearfish Mountain Plans Audiology Assoc Spearfish Richard Keim, M.D. Spearfish Black Hills Psychology 12 25 2 $ 7,252.48 Vermillion Thomas Olson, M.D. Vermillion Robert Packard, Ph.D. 9 12 1 $ 2,233.44 Vermillion Dan Reiffenberger, M.D. 4 4 $ 1,223.38 Vermillion Galen Van Kley, Ph.D. Vermillion Michael Moran, M.D. Vermillion Sanford Vermillion Hospital Watertown Prairie Lakes Health Care Watertown Robert Packard, Ph.D. Watertown Dan Reiffenberger, M.D. Watertown Professional Hearing Svs Watertown Michael Moran, M.D. Watertown Prairie Lakes Hospital - X-Ray Watertown Robert Buri, Ph.D. Watertown Jorge Sanchez, M.D. Watertown CE Provider Services - Watertown Watertown Lee Hendricks, Psy.D. 8 17 1 $ 6,328.08 Webster Elizabeth Gravley, M.D. Winner (b) (6) Winner Regional Health Care Ctr Winner Winner Regional Hospital - Radiology Winner Audiology Assoc Winner Avera Winner Medical Clinic 5 21 2 $ 1,330.97 Winner Winner Regional Clinic Yankton Yankton Medical Clinic 1 1 $ 77.36 Yankton Todd Farnham, Aud, CCC-A 1 Yankton Lewis & Clark Behavioral Health 5 27 2 $ 1,861.20 Yankton Sacred Heart Hospital - X-ray Yankton Galen Van Kley, Ph.D. 15 37 4 $ 10,286.60 Yankton Psychological Assoc of Yankton 1 35 1 $ 620.40

TOTALS 679 12 156 $ 254,180.14 Auth City Vendor # Vendor # of Exams Exam - Report # Cancel Paid Total 7/1/17 - 9/28/17 Aberdeen John Vidoloff, M.D. Aberdeen (b) (6) Avera St. Luke's - RT Aberdeen Avera St. Luke's - Speech Therapy Aberdeen Pat Couglin, M.S. Aberdeen Steven Redmond, M.D. Aberdeen Avera St Luke's Peds PT Aberdeen Marshall Dorsett. O.D Aberdeen Francine Sippel, Ed.D. Aberdeen Edward D'Souza, M.D. Aberdeen Avera St. Luke's - Radiology Aberdeen Lutheran Social Services Aberdeen CE Provider Services Aberdeen Sanford Aberdeen Med Ctr Aberdeen KLM Medical Svs - Aberdeen Aberdeen Dakota Counseling Group Bismarck Med Center One Bismarck UND Center for Family Medicine Bismarck Link Psychological Svs Bismarck Krista Heil, O.D. Brookings Merritt Warren, M.D. Brookings Yorkshire Eye Clinic Brookings Thomas Shaffer, Ph.D. Brookings Avera Brookings Medical Clinic Chamberlain John Jones, M.D. Chamberlain Karen Wiemers, Ph.D. Chamberlain Audiology Associates Chamberlain CE Provider Svs - Chamberlain Chamberlain Sanford Chamberlain Clinic Chamberlain Alexander Permann, O.D. Eagle Butte Lynn Goehring, M.A, Freeman Kenneth Kirton, M.D. Gregory Gregory HealthCare Center-Hospital Gregory Avera Gregory Med Clinic Hot Springs Daniel Hafner, M.D. Huron Frank Dame, Ph.D. Huron Community Counseling Svs Huron Huron Regional Med Ctr Huron Gregory Wiedel, M.D. Huron CE Provider Services - Huron Huron KLM Medical Svs - Huron Lake Andes Richard Honke, II, M.D. Lemmon Shirley Herbel, Ph.D. Madison Bernard Heilman, M.D. Madison Richard Sample, M.D. Madison Madison Community Hospital - X-ray Madison Community Counseling Svs Miller Audiology Assoc - Miller Mission Maryann Coupland, Ph.D. Mitchell David Malters, M.D. Mitchell (b) (6) Avera Queen of Peace - RT Mitchell Hearing Plus Mitchell Avera Queen of Peace - Dr. Cho Mitchell Avera Queen of Peace - Speech Mitchell Matthew Christiansen, Ph.D. Mitchell Children's Care Hospital & School - OT/PT Mitchell Jorge Sanchez, M.D. Mitchell Mabee Eye Clinic Mitchell Dakota Physical Therapy Mitchell Galen Van Kley, Ph.D. Mobridge Mobridge Regional Hospital Parkston Richard Honke, II, M.D. Parkston Jason Wickersham, M.D. Parkston Antoinette Vanderpol, M.D. Parkston Christopher Boschee, D.O. Parkston Larissa Sanger, M.D. Pierre Stephen Stout, M.D. Pierre Lynn Goehring, M.A. Pierre Capital Area Counseling Svs Pierre St. Mary's Hospital - RT Pierre Audiology Assoc Pierre St. Mary's Hospital - Speech Pierre St. Mary's Hospital - OT Pierre St. Mary's Hospital - X-ray Pierre Jodi Owen, Psy.D. Pine Ridge Marv Bouska, M.S. Pine Ridge Greg Swenson, Ph.D. - OLC PR College Ctr Pine Ridge Greg Swenson, Ph.D. Rapid City Daniel Hafner, M.D. Rapid City Steven Hata, M.D. Rapid City Robert Nixon, M.D. Rapid City Richard Renka, M.D. Rapid City J. Geoffrey Slingsby, M.D. Rapid City Willis Sutliff, M.D. Rapid City Alvin Wessel, M.D. Rapid City Greg Swenson, Ph.D. Rapid City Rapid City Regional Hospital - RT Rapid City Mountain Plans Audiology Assoc Rapid City Scott Cherry, Ph.D. Rapid City Black Hills Rehab Hospital Rapid City Craig Mills, M.D. Rapid City Mark Perrenoud, Ph.D. Rapid City Marv Bouska, M.S. Rapid City Jackie Gilbertson, Ed.D. Rapid City Lifescape - Motor Skills Rapid City Lifescape - Speech Rapid City Black Hills Rehab Hospital Rapid City Dewey Ertz, Ed.D. Rapid City (b) (6) David R. Johnson, M.D. Rapid City Paul Zimmerman, M.D. Rapid City Christina Cote, D.O. Rapid City Monte Dirks, M.D. Rapid City Dakota Radiology Rapid City William Moss, Psy.D. Rapid City Rolf Norlin, M.D. Rapid City Donald Blower, M.D. Rapid City Brett Valette, Ph.D. Rapid City Stuart Krause, Ph.D. Rapid City John Lassegard, M.D. Rapid City Black Hills Psychology Rapid City Scott Scrriber, O.D. Rapid City Regional Rehab Institute Sioux Falls Paul Cink, M.D. Sioux Falls Leonard Gutnik, M.D. Sioux Falls Michael McGrath, Ph.D. Sioux Falls Avera McKennan Hospital - RT Sioux Falls Sanford USD Medical Ctr - RT Sioux Falls Center for Family Medicine Sioux Falls Susan Assam, M.D. Sioux Falls Kelcey Cushman, Aud Sioux Falls Sanford Rehab Speech Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) Sioux Falls CCHS Rehabilitation Ctr Sioux Falls Sanford-Radiology Sioux Falls Stanford Hearing Sioux Falls Thomas Price, Ph.D. Sioux Falls Brian Kidman, M.D. Sioux Falls Tracy Stephens, Ph.D. Sioux Falls Tom Styz, M.D. Sioux Falls Jorge Sanchez, M.D. Sioux Falls Rebecca Watson-Miller, Ph.D. Sioux Falls Galen Van Kley, Ph.D. Sioux Falls Martha Socolofsky, M.D. Sioux Falls Andrea McCann, O.D. Sioux Falls Ophthalmology Ltd Sioux Falls Emily Blegen, Psy.D. Sioux Falls Sioux Falls Family Vision Sioux Falls Kayla Norenberg, M.D. Sioux Falls Nicholas Venosdel, M.D. Sioux Falls Avera Mckennan Hospital - Audiology Sioux Falls Avera Audiology Clinic Sioux Falls Vitality Psychological Svs Sioux Falls Midwest Ear, Nose & Throat Sisseton Coteau Des Prairies Hospital Spearfish Mountain Plans Audiology Assoc Spearfish Richard Keim, M.D. Spearfish Black Hills Psychology Vermillion Thomas Olson, M.D. Vermillion (b) (6) Robert Packard, Ph.D. Vermillion Dan Reiffenberger, M.D. Vermillion Galen Van Kley, Ph.D. Vermillion Michael Moran, M.D. Vermillion Sanford Vermillion Hospital Watertown Prairie Lakes Health Care Watertown Robert Packard, Ph.D. Watertown Dan Reiffenberger, M.D. Watertown Professional Hearing Svs Watertown Michael Moran, M.D. Watertown Prairie Lakes Hospital - X-Ray Watertown Robert Buri, Ph.D. Watertown Jorge Sanchez, M.D. Watertown CE Provider Services - Watertown Watertown Lee Hendricks, Psy.D. Webster Elizabeth Gravley, M.D. Winner Winner Regional Health Care Ctr Winner Winner Regional Hospital - Radiology Winner Audiology Assoc Winner Avera Winner Medical Clinic Winner Winner Regional Clinic Yankton Yankton Medical Clinic Yankton Todd Farnham, Aud, CCC-A Yankton Lewis & Clark Behavioral Health Yankton Sacred Heart Hospital - X-ray Yankton Galen Van Kley, Ph.D. Yankton Psychological Assoc of Yankton

TOTALS Auth City Vendor Volume Providers Onsite Review Completed Rapid City Brett Valette, Ph.D. Rapid City John Lassegard, M.D. Rapid City Jackie Gilbertson, Ed.D. X Rapid City Rolf Norlin, M.D. X Sioux Falls Brian Kidman, M.D. Sioux Falls Thomas Price, Ph.D. Eagle Butte Lynn Goehring, M.A, Mission Maryann Coupland, Ph.D. Sioux Falls Michael McGrath, Ph.D. Rapid City Greg Swenson, Ph.D. Mitchell Galen Van Kley, Ph.D. Spearfish Black Hills Psychology Pierre Lynn Goehring, M.A. Sioux Falls Emily Blegen, Psy.D. Yankton Galen Van Kley, Ph.D. Sioux Falls Vitality Psychological Svs Rapid City Dakota Radiology Huron KLM Medical Svs - Huron X Sioux Falls Center for Family Medicine Aberdeen KLM Medical Svs - Aberdeen X Sioux Falls Nicholas Venosdel, M.D. Watertown Lee Hendricks, Psy.D. Rapid City Stuart Krause, Ph.D. X Rapid City Marv Bouska, M.S. Sioux Falls Galen Van Kley, Ph.D. Pine Ridge Marv Bouska, M.S. Aberdeen Dakota Counseling Group Sioux Falls Rebecca Watson-Miller, Ph.D. Aberdeen Steven Redmond, M.D. Vermillion Robert Packard, Ph.D. Aberdeen Lutheran Social Services Rapid City Dewey Ertz, Ed.D. Vermillion Galen Van Kley, Ph.D. Parkston Larissa Sanger, M.D. Huron Community Counseling Svs Chamberlain Karen Wiemers, Ph.D. Watertown Robert Buri, Ph.D. Aberdeen Emily Blegen, Psy.D. Vermillion Dan Reiffenberger, M.D. Gregory Avera Gregory Med Clinic Yankton Lewis & Clark Behavioral Health Rapid City Daniel Hafner, M.D. Winner Avera Winner Medical Clinic Mitchell Matthew Christiansen, Ph.D. Rapid City Rapid City Regional Hospital - RT Parkston Antoinette Vanderpol, M.D. Rapid City Lifescape - Speech Sioux Falls Kayla Norenberg, M.D. X Pierre Jodi Owen, Psy.D. Brookings Yorkshire Eye Clinic Yankton Psychological Assoc of Yankton Parkston Jason Wickersham, M.D. Parkston Richard Honke, II, M.D. Brookings Merritt Warren, M.D. Freeman Kenneth Kirton, M.D. Sioux Falls CCHS Rehabilitation Ctr (Speech/AU, motor) Lake Andes Richard Honke, II, M.D. Huron Gregory Wiedel, M.D. Aberdeen Francine Sippel, Ed.D. Huron Frank Dame, Ph.D. Rapid City Alvin Wessel, M.D. Sioux Falls Sanford USD Medical Ctr - RT Sioux Falls Avera McKennan Hospital - RT Aberdeen Marshall Dorsett. O.D Chamberlain John Jones, M.D. Chamberlain Alexander Permann, O.D. Sioux Falls Paul Cink, M.D. Mitchell Avera Queen of Peace - RT Rapid City Mountain Plans Audiology Assoc Pierre St. Mary's Hospital - Speech Aberdeen Avera St. Luke's - RT Yankton Yankton Medical Clinic Madison Bernard Heilman, M.D. Watertown Michael Moran, M.D. Mobridge Mobridge Regional Hospital Aberdeen Avera St. Luke's - Speech Therapy Rapid City Regional Rehab Institute Sioux Falls Stanford Hearing Mitchell Hearing Plus Watertown Prairie Lakes Health Care Pierre St. Mary's Hospital - RT Huron Huron Regional Med Ctr Sioux Falls Susan Assam, M.D. Sioux Falls Sanford Rehab Speech Rapid City Lifescape - Motor Skills Rapid City Richard Renka, M.D. Sioux Falls Midwest Ear, Nose & Throat Yankton Sacred Heart Hospital - X-ray Sioux Falls Avera Audiology Clinic Mitchell Dakota Physical Therapy Rapid City Black Hills Rehab Hospital Sioux Falls CCHS Rehabilitation Ctr Chamberlain Audiology Associates Winner Audiology Assoc Pierre Audiology Assoc Spearfish Mountain Plans Audiology Assoc Watertown Professional Hearing Svs Rapid City Black Hills Rehab Hospital Yankton Todd Farnham, Aud, CCC-A Pierre St. Mary's Hospital - OT Vendor Name Key And Volume CE Panelist CE Panelists Removed For Tennessee FY 2017 Providers Onsite Inactive License, Sanction Review Or Removal For Cause and Reason ALLRED, TRACY L Key Provider Based On CE Work 11/15/2016 ALL WAYS THERAPIES Cook, Candice M APPALACHIAN PSYCHOLOGICAL C 6/7/2017 Spangler, Robert ASSESSMENT AND FORENSIC SER 6/6/2017 Birchfield, Sarah Fuchs, Jorge Jones, Elizabeth Sims, Willard Visser, Preston Whitehead, Diane ATHENS MEDICAL SERVICES LLC Key Provider Based On CE Work 6/14/2017 ATHENS PSYCHOLOGICAL & COUNKey Provider Based On CE Work 6/14/2017 AUDIOLOGY SERVICE OF CHATTA Parker, Kenneth AVAZA LANGUAGE SERVICES COR BARKER, MARY L 11/15/2016 BARKLEY & ASSOCIATES Barkley, Janice L Barkley, Philip H Quarto, Christopher J BEHAVIORAL HEALTH & ASSESSM Moore, Hugh D BEHAVIORAL SCIENCE CONSULTI Key and Volume Provider-Top 5 11/10/2016 Fulliton, William L Gammel, Heather Miller, Paula Myszak, Jessica BLAKE, CANDICE L 11/18/2016 BLANTON, KEVIN Key Provider Based On CE Work 3/7/2017 BLAZINA, LINDA Key Provider Based On CE Work 8/14/2017 BRENTWOOD HEARING CENTER Boling, Anne Mozingo, Kimberly Williams, Tania BRIDGEWATER SPEECH & HEARIN 3/7/2017 Baerman, Sally J Rossini, Tabitha BRISTOL EVALUATION SERVICES Key Provider Based On CE Work 6/6/2017 Palmer, Anna Smith, Wade BRISTOL MEDICAL SERVICES IN Key Provider Based On CE Work 6/6/2017 BRISTOL PSYCH & COUNSELING Key Provider Based On CE Work 6/6/2017 CALDWELL, KATHY 2/8/2017 Geter, Jennifer CAMP, DIANE Key Provider Based On CE Work 11/10/2016 CAMPBELL CUNNINGHAM & TAYLO 3/7/2017 Campbell , Philip D Cole, Matthew Cunningham,Leslie B Everett, Gregory Haun, Alden Hildebrand, Allyn Horton, Daniel Molloy, Brents Stone, Lauren Sussmane, Shawn Taylor, Christopher Tonks, Meredith CENTER FOR AUDIOLOGY PC Carr, Aubrey J Crockett, Katelyn LeJeune, Emiko CENTER FOR SIGHT 3/9/2017 Franklin, Stephen O'Brien, Christopher Patrick Raulston, Kenneth CHATTANOOGA SERVICES LLC Key and Volume Provider 1/18/2017 CLARKSVILLE SERVICES LLC Key Provider Based On CE Work 2/28/2017 COGNITIVE BRIDGES INC 2/8/2017 Pollack, Sharon Schultz, Charlotte COLUMBIA MEDICAL & PSYCHOLOKey Provider Based On CE Work 9/25/2017 COLUMBIA ORTHOPEDIC CLINIC H. James Wiesman, MD COMMUNICATION CENTER FOR DE COOKEVILLE PSYCH & COUNSELI Key Provider Based On CE Work 8/14/2017 COOKEVILLE SERVICES LLC Key Provider Based On CE Work 8/14/2017 CRISLER, HERMAN JR CUMBERLAND MEDICAL EVALUATKey and Volume Provider-Top 5 6/8/2017 Uzzle, Jeffrey A DEAFCONNECT OF THE MIDSOUTH DENNY, ELLEN Key Provider Based On CE Work 3/7/2017 DIAGNOSTIC CENTER Key Provider Based On CE Work 6/14/2017 Mullady, Thomas F DIAGNOSTIC ULTRASOUND CONSU Davis Ellis, Nancy C. Eiland, Douglas Flinn Jr., George S. DICKSON MEDICAL INC Key Provider Based On CE Work 9/12/2017 DOINEAU, DEBBIE Key Provider Based On CE Work 12/14/2016 DORAN, ROBERT N 2/28/2017 Phillips, Mark DR ABRAHAM BRIETSTEIN & ASS 3/7/2017 Brietstein, Abraham DR GUINLE & ASSOCS 11/19/2016 Guinle, Michael DUNCAN EYE PLLC 2/9/2017 Duncan, Kristen Graves, Emily T DYERSBURG MEDICAL ASSOCIATEKey Provider Based On CE Work 5/15/2017 EAR NOSE & THROAT CONSULTAN Hayes, Jonathan Johnson, Clifford Overholt, Samuel Seals, James Seals, Michael Sexton, David Wheless, Stephen EAST TN PSYCHOLOGICAL ASSOC Key Provider Based On CE Work 3/7/2017 EDWARDS, SHARON M Key Provider Based On CE Work 12/14/2016 ENGSTROM SERVICES, INC 6/14/2017 Wheeler, Janice K EVALUATION SPECIALISTS Key Provider Based On CE Work 6/8/2017 Brody, Pamela Brown, Larry Hawthrone, Michael C EYE CARE CHATTANOOGA PLLC Nicola, Paula EYE CENTERS OF TENNESSEE LLC Elder, Jennifer Peek, Jennifer Leann EYE CLINIC 5/16/2017 Bateman, Mark Grissom, Hilary Lee, Molly Luka, Adam Neel, Sean Sullivan, Jason EYE SPECIALISTS ASSOCIATION Currey, Thomas FAMILY EYE CARE OF JOHNSON 6/7/2017 Grist, Dana FAMILY HEARING CENTER INC Gresham, Jill McDermott, Ashley Stone, Sue FAMILY WELLNESS CENTER 2/28/2017 Martin, Janice Premeau, Cheri Terrell, David FAYETTEVILLE MEDICAL SVCS G Key Provider Based On CE Work 6/30/2017 FAYETTEVILLE PSYCHOLOGICAL Key Provider Based On CE Work 6/30/2017 FISHER, TIMOTHY M FOLEY, THELMA GALE, SCOTT J GOMEZ, ALBERT J GREEN, REBECCA ANN 1/19/2017 GUARDIAN EYE ASSOCIATES PLC 2/28/2017 Frey, Walter HAND, BOBBIE J HARDISON, STEPHEN R Key Provider Based On CE Work 8/14/2017 HARRIS SPEECH THERAPY Harris, Jennifer M HAWKINS, LEAH T HEALTH MANAGEMENT SERVICES 6/14/2017 Biller, Benjamin Biller, Tom Milliron, Trevor HEALTHSTAR PHYSICIANS 6/6/2017 Nevils, Roy HEALTHSTAR PHYSICIANS McConnell, David HEARING & BALANCE CENTERS O Frederick, Lori House, Courtney Tackett, Katherine Tidwell, Kaitlyn HEARING BRIDGES HEARING CONSERVATION ASSOC Carroll, James R Jr HENDERSONVILLE MEDICAL SVCSKey Provider Based On CE Work 2/28/2017 HENDERSONVILLE PSYCHOLOGICAKey Provider Based On CE Work 2/28/2017 HENRY, BERTRAM HERMAN, JEFFREY SCOTT LPC Valerio, Carolyn HIGHLANDS PSYCHOLOGICAL GROKey Provider Based On CE Work 9/25/2017 HILLSIDE HOSPITAL HOLCOMBE, SAMUEL A 2/9/2017 HOLLAND, WILLIAM A Key Provider Based On CE Work 1/18/2017 HUANG, LLOYD 12/14/2016 HUMPHREYS, BRIAN 3/10/2017 JACKIE-D-YAK LLC Dunn, Jacqueline JACKSON CLINIC NORTH Warmbrod, James G JACKSON MADISON CO GEN HOSP JACKSON SERVICES LLC Key Provider Based On CE Work 5/6/2017 JCIL DEAF SERVICES JD ASSOCIATES 2/22/2017 Carroll, Jana A Greer, Melissa JENKINS, WILLYN 2/9/2017 JOHNSON CITY EYE CLINIC Johnson, John Miller, Calvin Shahbazi, Michael JOHNSON CITY PSYCHOLOGICAL Key Provider Based On CE Work 6/7/2017 JONES THERAPY SERVICES LLC Battles, Cornelia Carrico, Kailin Cox, Emaly DeStefano, Andria Eibl, Emily Ferguson, Jan Freel, Terah H. Hinson, Rachel Hitch, Christine Horton, Susan Johns, Shannon Jones, Ginger Kakenmaster, Claire Maffett, Elizabeth Palmer, Kathleen Ritz, Chelsea Sepp, Chelsea Shea, Lori Smith, Tara Vannelli, Dominique Womack, Margeaux Wood, Kendra KENNON, ROBERT W 12/14/2016 KILLIAN, JERELL F KINGSPORT MEDICAL SERVICES Key Provider Based On CE Work 6/6/2017 KINGSPORT PSYCH & COUNSELIN Key Provider Based On CE Work 6/6/2017 KNOXVILLE CENTER OF THE DEAF KNOXVILLE SERVICES LLC Key Provider Based On CE Work 3/7/2017 KRIGER, SIDNEY H 2/9/2017 Battles, Michelle A LAAMBDA HEALTHCARE, INC Key Provider Based On CE Work 11/9/2016 Mohan, Kamal LACY & ASSOCIATES 12/14/2016 Collins, Millard Lennon, Christen Schuster, Daniel Yawn, Robert LAMBERT, DOROTHY LANTHORN, B WAYNE 6/7/2017 Abbott, Donna LAWHON, STEVEN LAWRENCE, HARRY M LITTLE, WILLIAM B 11/8/2016 Little, William B Little, William B Jr LOFTIS, MARK 8/14/2017 LOSKOVITZ, LEWIS 2/8/2017 LUCAS, DEANNE RIESS 3/9/2017 MABRY EYE CENTER 1/19/2017 Mabry, Elizabeth MAFFEO, PATRICIA A Key Provider Based On CE Work 3/10/2017 MAURY REGIONAL HOSPITAL MAY, C RANDALL McMINNVILLE MEDICAL SERVICE Key Provider Based On CE Work 10/26/2016 McMINNVILLE PSYCHOLOGICAL &Key Provider Based On CE Work 10/26/2016 MEDICAL AND PSYCHOLOGICAL Key and Volume Provider-Top 5 6/30/2017 MEDICAL CARE PLLC Filka, Marianne MEDICAL SPECIALISTS OF KNOX Key Provider Based On CE Work 11/15/2016 Summers, Jeffrey S MEMPHIS HEARING AID & AUDIO Aven, Marva Cox, Benton Dawkins, Sarah Killins, Carla Lunsford, Rachel McLellan Booth, Rena Rude, Michael J Springer, Catelin Thompson, Marjorie Lisa MEMPHIS MEDICAL ASSOCIATES Key and Volume Provider-Top 5 11/9/2016 MEMPHIS NEUROLOGY PLLC Jacob, Sajish Lynn, Ronald Natarajan, Shiva Shankar MID SOUTH HEART CENTER PC Cunningham, Louis MIDDLE TN EAR NOSE & THROAT Converse, George M Ford, Vicki L Fordice. James O Phelps, Aurora M Smith, Alissa MIDDLE TN OCCUPATIONAL AND 8/14/2017 Johnson, Roy P Chernowitz, Alexander MISRA, EVA Key Provider Based On CE Work 3/9/2017 MORRISTOWN MEDICAL ASSOCIAKey Provider Based On CE Work 6/6/2017 MORRISTOWN PSYCHOLOGICAL GKey Provider Based On CE Work 6/6/2017 MOUNTAIN REGION SPEECH AND 6/6/2017 Arwood, Kathleen Brady, Matthew Claytor, Carol Collins, Brittany Davis, Courtney Maas, Dallas Payne, Paula Rowe, Kristi Rushing, Brittany Smith, Jessi Watson, Rebekah Wolfe, Rachel MURFREESBORO SERVICES LLC Key Provider Based On CE Work 10/26/2016 NASHVILLE MEDICAL SERVICES Key Provider Based On CE Work 12/14/2016 NASHVILLE PSYCH & COUNSELIN Key Provider Based On CE Work 12/14/2016 NEUROLOGY OUTREACH CLINICS Al-Hamda, Ahmad Assaf, Mohammad NORTHGATE NEUROLOGY PLLC Gibson, Larry Mance, Cornelius J NU CARE Key Provider Based On CE Work 2/28/2017 Dake, Thomas Robinson, William ON-SITE SWALLOWING DIAGNOSTI 2/8/2017 Fleming, Wendy OPTIMUM BEHAVIORAL HEALTH I 2/10/2017 Amos, W. Edward O'TOOLE, THERESA 2/9/2017 PALMER, LARRY PARIS MEDICAL SERVICES INC Key Provider Based On CE Work 4/5/2017 PARIS PSYCHOLOGICAL & COUNS Key Provider Based On CE Work 4/5/2017 PARIS SPEECH AND LANGUAGE CL 4/5/2017 Taylor-Nanney, Elizabeth Leigh Watt, Rhonda PARKWEST MEDICAL CENTER PARTNERSHIP FOR FAMILIES PATTERSON, LISA N PREMIER DIAGNOSTIC IMAGING Coonce, Daniel Humphrey, William M. Limbacher II, John P. Means, Seth PSYCHOLOGICAL DIAGNOSTIC GRKey Provider Based On CE Work 1/19/2017 Caye, David J Judd, John B Martin, Charles Ramey, Ann PSYCHOLOGICAL SERVICES Key and Volume Provider 9/12/2017 Altfeld, Toby Brown, Paul Cowie, James Dietrich, David Fitzpatrick, Elliott Hooper, Valerie McSpadden, Anne Price-Verdell, Katie Beth Rnard, Deborah Zager, Lynne D PSYCHOLOGICAL SERVICES OF M Gary, Sharon D Goldstein, David B Myers, Paula PSYCHOLOGY SPECIALISTS Adams, Perry Mealer, Cynthia QUINCE NURSING & REHABILITA Awad-Letteri, Trinity Eckard, Andrea Fioranelli, Mia Claire Gatlin, Melanie Sigman, Susan R. SCOTT BEEBE PHD Bolton Beebe, Amy RANDOLPH OCCUPATIONAL MEDKey Provider Based On CE Work 11/9/2016 Randolph, Bruce W Wisdom, Randall T RUDOLPH, CHARLES 1/19/2017 SAINT FRANCIS CARDIOLOGY AS Awdeh, Mahir Cohen, Avrahm Das, Pranab Janjua, Muhammad Rudorfer, Bennet Simmons, David Zafarullah, Haris SHERROD, KATHRYN B 12/14/2016 Turley, Marie SIEGEL, BARRY Key Provider Based On CE Work 11/9/2016 SMITH, KATHRYN R Key Provider Based On CE Work 3/7/2017 SPEECH AND HEARING CENTER 1/19/2017 Andrews, Allison Chaplin, Ursula Ellis, Kelli Grear, Stephanie Harper, Meredith Hosterman, Pam Lagunas, Maribel Wiksell, Carla SPEECH PATHOLOGY SERVICES O Beckmann, Bobbie Bradburn, Julie Buttrey, Britney Copeland, Katherine Graves, Sherri Gray, Rebecca Hazelbaker, Jillian Helton, Karen Hill, Elizabeth A. Howe, Debra Wyssmann, Rebecca Murname, Kaelen Ostrar, Elisheva Payne, Deborah SPJUT, DENNIS 6/5/2017 ST FRANCIS MEDICAL PARTNERS 11/10/2016 Gouveia, Nurela STEELE, KATHRYN TAKOMA REGIONAL HOSPITAL 6/5/2017 Filka, Marianne Lewis, Daniel THE MEDICAL MATTER LLC Key and Volume Provider 12/15/2016 Ellis, Ira Keith Johnson, Jennifer McBride, Gary Temple Dustin Grey Weaver, Steven Glenn TRI-CITIES SERVICE GROUP IN Key and Volume Provider 6/7/2017 TULLAHOMA HMA TULLAHOMA SERVICES LLC Key Provider Based On CE Work 6/30/2017 UNIV OF TN HEARING & SPEECH Buehler, Velvet Hamby, Ellen Hedinger, Tricia Hume, Sue Irick, Ashley Mills, Carren Noss, Emily Radford, Nora Sanderson, Autumn Vaughn, Teresa Wegman, Allison Wilson, Jennifer UT LEBONHEUR PEDIATRIC 2/8/2017 Banks, Casandra Haddix, Vicki Long, Helen Marshall, Julie Merrill, Jo Claire Sandidge, John Smith, Eileen Taylor, Jennifer P. Wark, Marilyn White, Melanie VANDERBILT BILL WILKERSON CTR VIERS, JEFFREY W Hanket, Jennifer W R STAUFFER MD & ASSOCIATE Key and Volume Provider 12/14/2016 Barnett, Donald Chuck, Frank Cistola, Carol Dorris, Stacy L Kirkpatrick, James Lynch, J. Michael WATAUGA HEARING CONSERVATIO Abkes, Bruce Howell, Mark Light, Keri Pilkenton-Johnson, Toby Winstead, Johnathan Zajonc Jr., Timothy WATSON PRIMARY CARE AND GEN 9/12/2017 Watson, Stephen Mark WELLCARE INC Key Provider Based On CE Work 2/22/2017 Dake, Thomas Jackson, Charolette Robinson, William Sweets, Thomas WELLMONT HLTH SYS/HOLSTON V WEST TENN HEARING & SPEECH Gaston, Rhonda McGuire, Jennifer Merwin, Caroline Moore, Kimberli Sams, Kimberly WEST TENNESSEE PSYCHOLOGICAKey and Volume Provider-Top 5 5/15/2017 WILSON, DENNIS W Key Provider Based On CE Work 4/5/2017 WOOD, FRANK WORDS FOR LIFE SPEECH AND LAN Prestininzi, Cassie

MULTIPLE OFFICE ROTATING MEDICAL DOCTORS Blaine, Robert Goewey, Stephen Huffman, William Keown, Donita Leveck, Terrence Wilson, Woodrow Yates, Linda

MULTIPLE OFFICE ROTATING PSYCHOLOGISTS Arsenault, Adam Berry-Sawyer, Kimberlee Campbell, Jerry "Jay" Cheah, E-Ling Gaines, Michelle V Garland, Alice K Germek, Mistie Gilleylen, Carl Grant, Kristin Hester, Sam B. Hopko, Derek James, Barbara Kocian, Angella Langford, Dee Moise McQuain, Karla Porter, Melissa Raphaeli, Tamara Sawyers, Pauline Sophia Sims, Chad Smith, Greta Smith, Walter Edward "Ed" Utah FY 2017

Key Volume Provider? State License State License State Disciplinary Top five or primary CE Provider's Name Expiration Date Number Action? Onsite Review work? Company Allred, Aaron 9/30/2018 No Artis Forensic as of 5/27/2016

Anderson, Chad W. 1/31/2018 (b) (6) No Mountain Eye Institute-9/11/17 Anderson, Christopher D. 9/30/2018 No Starting with Artis June 2017

Andrus, Kyle 9/30/2018 No Optometrist, St. George Arnesen, Brian 9/30/2018 No Psychologist DES, CO (Bayfield or Grand Junction) as of Baca, Edwin L. (Colorado) 4/30/2019 No 11/02/16. Still with DES as of 4/2017 Barnett, Kathy 9/30/2018 No 7/18/2017 Psychologist Barney, Steve 9/30/2018 No Psychologist Speech pathologist, UVRMC as of 5/6/16. Still Baxter, Amy 5/31/2019 No there as of 11/07/2016 Speech pathologist, Dixie Speech as of 2015. Still there as of 12/20/2016. Still there as of Bitton, Sidena 5/31/2019 No 5/2017

Bloom, Ashley (Colorado) 4/30/2019 No DES, CO as of 4/19/16 (Grand Junction) Speech pathologist, UVRMC. Still there as of Bolick, Shauna 5/31/2019 No 11/07/2016 Boman, Tel S. 5/31/2019 No Audiologist, Ogden Speech Booth, Eileen 9/30/2018 No New psychologist with Artis as of 01/2017 Borja, Charlene Estrada DES, CO (Bayfield or Grand Junction) as of (Colorado) 4/30/2019 No 11/02/16. Still with DES as of 4/2017

Bowen, Matthew 5/31/2018 No Physical doc, Vernal as of 10/2015

Bowen, Megan 9/30/2018 No Brass, Jamie 9/30/2018 No 5/10/2017 Psychologist Audiologist, UVRMC. Still there as of Bumgardner, Jared 5/31/2019 No 11/07/2016 Audiologist, Advanced Hearing & Balance St. Burrows, Jacob 5/31/2019 No George as of 3/2015 Cantor, Mark 5/31/2019 No Speech pathologist, UofU since 2/2015

(b) (6) 7/26/17, Price office. Carlisle, Al (Alma) 9/30/2018 Psychologist

Charlton, Kevin 1/31/2018 No Ophthalmologist, Rocky Mtn. Eye

Christian, Rory 9/30/2018 No Mountain Eye Institute-9/11/17 Clark, Margaret 5/31/2019 No Audiologist, ENT Center in SLC Yes-Top five & primary Colledge, Tanya 9/30/2018 No CE work Psychologist Corgiat, Mark D. 9/30/2018 No Psychologist Dastrup, Benjamin 1/31/2018 No Opthalmologist, Country Hills Eye Center DeBerard, Scott (Michael) 9/30/2018 (b) (6) No Psychologist DES, CO as of 4/19/16 (Grand Junction). Still Dewey, Michael (Colorado) 4/30/2019 No with DES as of 4/2017

Duncan, Clinton 1/31/2018 No Mountain Eye Institute-9/11/17 Duncan, Dee 9/30/2018 No Psychologist Dunne, Catherine Connell DES, CO (Bayfield or Grand Junction) as of (Colorado) 4/30/2019 No 11/02/16. Still with DES as of 4/2017 Eisemann, Sandra (Colorado) 8/31/2019 No Psychologist, CO Ericksen, David G. 9/30/2018 No Psychologist Dr. Fong owns Artis Forensic: Ogden 5/10/17, Yes-Top five. This is the Salt Lake City 7/18/17, Price owner of the company, Fong, Alina 9/30/2018 No 7/26/17. Artis Forensic. Psychologist (owner of Artis Forensic) Audiologist, Advanced Hearing & Balance St. Forbes, Kimball 5/31/2019 No George Speech pathologist, UVRMC as of 5/6/2016. Fowler, Courtney 5/31/2019 No Still there as of 11/07/2016 Foye, Mary 5/31/2019 No UMC as of 4/25/2016 Dr. Fyans & Dr. Joseph Nelson: Provo 1/30/17, St. Mark's 2/16/17, Ogden Fyans, Joseph 1/31/2018 No 5/10/17 Yes-Top five Physical doc, Canyon Medical Fue, Laurie 5/31/2019 No Speech pathologist, UMC as of 4/25/2016 Gaeto, Hollie 4/30/2019 No DES, CO. Discovered 4/2017 Speech pathologist, Castleview Hospital as of 7/26/2017 Greenhalgh, Taylor 5/31/2019 No 3/2015 Audiologist, Advanced Hearing & Balance St. Greer, Lance 5/31/2019 No George Speech pathologist, UVRMC. Still there as of Grotegut, Timothy 5/31/2019 No 11/07/2016 Hales, Kimberly 5/31/2019 No Speech pathologist, UofU since 4/2017 Hancock, Kyle 9/30/2018 No Psychologist Hankins, Elizabeth 5/31/2019 No Audiologist, ENT Center in Draper Hanson, Hugh 5/31/2019 No Speech pathologist, Ogden Speech Hanson, Ryan 5/31/2019 No 7/26/2017 Audiologist, Price Yes-Top five & primary Hardy, John 9/30/2018 No CE work Psychologist Harris, Emily 9/30/2018 No Psychologist Hatch, Daniel 9/30/2018 No Psychologist as of 3/2015 New physical doctor, starting in Vernal, Head, Rex 1/31/2018 No January 2017

Speech pathologist @ Pediatric Rehab in Logan. Discovered 2/3/17. She works Hicken, Sara 5/31/2019 No Monday's only but may do interpreting for us Horn, Mary Leigh 5/31/2019 No Audiologist, ENT Center in Draper Audiologist, UVRMC. Still there as of Huffman, Todd 5/31/2019 No 11/07/2016 Yes-Top five & primary 7/18/17, Price location. Ingebretsen, Richard 1/31/2018 No CE work Physical doc, SLC, Brigham City & Price (b) (6) DES, CO, as of 6/17/2015 (Grand Junction). Jackman, Ryan (Colorado) 4/30/2019 No Still with DES as of 4/2017 1/30/17, Orem location. 3/30/17, Cottonwood Jay, Karla 5/31/2019 No Heights office. Speech pathologist, SLC & Orem

Jeppsen, Paul 1/31/2018 No Ophthalmologist, Rocky Mtn. Eye DES, CO (Grand Junction). Still with DES as of Kamer, Kerry (Colorado) 4/30/2019 No 4/2017 New speech pathologist, We Speak Speech Kellersberger, Tracy 5/31/2019 No Therapy as of 8/2017

Kilian, Adam 1/31/2018 No DES, Utah as of 01/2017

Kirk, Ronald 9/30/2018 No Optometrist, Blanding Kirsh, Janet 5/31/2019 No Speech pathologist, UofU since 2/2015 Kockler, Timothy 9/30/2018 No Psychologist Kraemer, Robert 5/31/2019 No Speech pathologist, UofU since 2/2015

Kuentzel, William (Bill) 1/31/2018 No Psychiatrist Speech pathologist @ Dixie Regional as of LaDow, Jessica 5/31/2019 No 12/2016. Still there as of 5/2017 Lidgard, Julia 5/31/2019 No Speech pathologist, UofU since 2/2015 Speech pathologist, UVRMC. Still there as of Liu, Tracy 5/31/2019 No 11/07/2016

Lloyd, Michael 1/31/2018 No Ophthalmologist, Utah Valley Eye Center Leroy, Molly 5/31/2019 No Audiologist, ENT Center in Draper Lobdell, Anne 5/31/2019 No Audiologist, UofU New psychologist in Blanding Utah as of Lyman, Michael 9/30/2018 No 11/2016 Lytle, Mary 5/31/2019 No Audiologist, UofU as of 8/2014 MacDowell, Grace 9/30/2018 No Psychologist, as of 9/02/2015 Audiologist, UVRMC (PRN basis only). Still Mahoney, Carla 5/31/2019 No there as of 11/07/2016 Mathy, Pamela 5/31/2019 No Speech pathologist, UofU since 2/2015 Audiologist, Cedar City Advanced Hearing & Maxwell, Eric 5/31/2019 No Balance McGill, Lizabeth 9/30/2018 No Psychologist, VBH McGirk, Blair 1/31/2018 No Physical doc New psychologist as of 6/2017, starting in 7/13/2017 McGoldrick, Keith 9/30/2018 No September 2017 Mehr, David 1/31/2018 No Physical doc Monson, Christian H. 9/30/2018 No Psychologist, Artis Forensic as of 5/6/2016

Morrill, Lynn (Lawrence) 5/31/2018 No Physical doc Speech pathologist, UVRMC. Still there as of Moss, James 5/31/2019 No 11/07/2016 Audiologist, UVRMC. Still there as of Moulton, B. Jess 5/31/2019 No 11/07/2016 Neider, Tristan 5/31/2019 No Speech pathologist, Ogden Speech Naidu, Susan 5/31/2019 (b) (6) No Audiologist, UofU as of 8/2014 Nelson, Duane 1/31/2018 No Opthalmologist, Utah Valley Eye Center Dr. Fyans & Dr. Joseph Nelson: Provo 1/30/17, St. Mark's 2/16/17, Ogden Nelson, Joseph W. 5/31/2018 No 5/10/17. Yes-Top five Physical doc, Canyon Medical Nichols, Andrew 9/30/2018 No Psychologist as of 1/2/2015 Norman, Leann 5/31/2019 No Audiologist, UofU as of 8/2014 Audiologist, UVRMC. Still there as of Norris, Mindy 5/31/2019 No 11/07/2016 Speech pathologist, UVRMC. No longer with UVRMC discovered 11/7/2016. Does work for Oliver, Jodi (previously Jodi Dixie Regional, discovered 12/20/2016. Stil Stroup) 5/30/2019 No there 5/2017 Orozco, Ashlee 9/30/2018 No New psychologist with Artis as of 02/2017 Speech pathologist, UVRMC. Still there as of Osborn, Paul 5/31/2019 No 11/07/2016 Parsons, Alison 9/30/2018 No Psychologist Speech pathologist, Dixie Speech, still performing exams as of 1/14/2014, stopped in 2015, started again (discovered 5/02/2016). Peters, Jane M. 5/31/2019 No Still there 5/2017 New speech pathologist, We Speak Speech Phifer, Melanie 5/31/2019 No Therapy as of 8/2017 Audiologist, USU in Logan as of 5/13/2016 Pitt, Cache 5/31/2019 No (HINT testing only for now) Physical MD, does OTO's only in Price as of 7/26/2017 Potter, Sterling 1/31/2018 No 5/27/2015 Audiologist, USU in Logan as of 5/13/2016 Preston, Elizabeth 5/31/2019 No (HINT testing only for now) Qutub, William (Colorado & 1/31/2018 (UT) & Utah) 4/30/2019 (CO) No DES UT & CO (owner)

Speech pathologist, Dixie Speech. Still there as Reber, Gregory 5/31/2019 No of 12/20/16. Still there as of 5/2017 Rebich, Scott 4/30/2019 No DES, CO as of 4/2017 Speech pathologist, UVRMC. Still there as of Reeves, LeAnn 5/31/2019 No 11/07/2016

Richards, Bradley 1/31/2018 No Ophthalmologist, Country Hills Eye Center Ririe, Jonathan 9/30/2018 No 1/30/17, Orem location. Psychologist Robinson, David M. 5/31/2019 No Audiologist, Hearing Zone Rottman, Randall (Colorado) 4/30/2019 No Ophthalmologist, Rottman Eye Care in CO Schreiner, Michael 9/30/2018 No Psychologist Silberman, Hilary 5/31/2019 No Speech pathologist, UofU since 2/2015 UVRMC speech pathologist. Still there as of 11/2016. 5/24/17: PRN basis only & may not Sparrow, Ashlee 5/31/2019 No even do CE's for us… Steed, Marc 9/30/2018 No 1/30/2017 New Psychologist in Orem as of 11/2016 Audiologist, Advanced Hearing & Balance St. Stirland, Spencer 5/31/2019 No George as of 12/21/2016 Swaner, Craig 9/30/2018 (b) (6) No 5/10/2017 Psychologist Physical doc, does OTO's only at ENT Center Tagge, Bryan 1/31/2018 No SLC & Draper Speech pathologist, UVRMC. Still there as of Taylor, Jennifer Shamy 5/31/2019 No 11/07/2016

Taylor, Kim 1/31/2018 No Ophthalmologist, Moran Eye Center Audiologist, PCMC as of 6/7/2016 (HINT Tonkovich, Kathryn 5/31/2019 No testing) Toohill, Martin 9/30/2018 No Psychologist Turgoose, Aaron 5/31/2019 No Audiologist, Lakeside Audio in Layton

Valencia, David Christopher 4/30/2019 No DES, CO as of 4/2017 Opthalmologist, Cache Valley Eye Assoc. in Waterman, David 1/31/2018 No Logan as of 9/4/2014 Watts, Rachel 5/31/2019 No Speech pathologist, UVRMC White, Shannon Noel 5/31/2019 No Audiologist @ PCMC as of 2/2017 Speech pathologist, Cache Kids Rehab in Whitworth, Harmony 5/31/2019 No Logan Wilkison, Pamela 9/30/2018 No Psychologist

Williams, Brice 1/31/2018 No Opthalmologist, Fred Clayson Eye Center

See Dr. Fyans & Dr. Nelson's Yes-Top five (company Zabel, Pierre 5/31/2018 No is, not this physician) Started with Canyon Medical 9/12/17

Past providers/Provider's that left this FY Allen, Jessica Cornett (Colorado)

Adams, Alicia Lynn (Colorado) Anderson, Dustin Joseph Matel Bergstrand, Lauren (Colorado) Brown, Carolynn Francavilla (Colorado)

Griffiths, Ashley

Hanson, Brian (Colorado) (b) (6)

Herbert, Aliea (Colorado)

Jendry, Ronald (Colorado) Johnson, Braeden (Colorado) Matergia, Michael (Colorado)

Moncrief, Laura Nelson, Breanna

Olson, Paul F.

Osborne, Mark (Colorado)

Parbhu, Rachel (b) (6)

Parbhu, Sheeva Kaushik

Pardyjak, Karen Simpson, Matthew (Colorado)

Wong, Carmen (Colorado)

Fakoya, Latifa Liebing, Madolyn

Moody, Richard Y.

Tueller, Stephen

Jeppson, Mayer

Call, Matthew

Linstroth, Lee Grow, Richard-RETIRED 8/16/17 Gurrister, Maria, no longer using Gurrister, Tom Turner, Jeffrey Lee, no longer w/ company Wagner, William-no longer w/ company

Graziano, Stacey

Vermont FY 2017

Organization/Provider Name Last Name First Name License Reason for Removal ADVANCED EYE CARE (b) (6)

* AMCE PHYSICIANS GROUP M.D. BANKS, MARK PH.D. BERGERON INGRAM, DANIELLE M.A. BONAZINGA, BARTHOLOMEW MD BRATTLEBORO HEARING CENTER BRATTLEBORO MEMORIAL HOSPITAL BRUTUS, MARTIN LCMHC CAMPBELL, SANDRA PSY. D. CARPENTER, MARC M.A. CENTRAL VERMONT EYE CARE CENTRAL VERMONT MEDICAL CENTER CHAMPLAIN IMAGING PLLC CONDON, ANNE LCMHC COPLEY HOSPITAL OPHTHALMIC CONSULTANTS OF VERMONT CORBITT SUZANNE O.D. DARTMOUTH HITCHCOCK (SECONDARY) DONNELLY, JOHN PH.D. DORR, MICHAEL M.S. EDITH, SALLY LCMHC ELEANOR M. LUSE CENTER EUREKA DIAGNOSTIC IMAGING P.C. FERNS-LEFEBVRE, RAQUEL M.A. FILKINS, KATHLEEN M.A. FULTON, ANDREW M.A. GIFFORD MEDICAL CENTER GIROUX, MARY-ELLEN M.A. GRACE COTTAGE HOSPITAL GURNEY, LORI M.S. HAYDEN, JOANNE M.A. HEDGEPETH, RONALD PHD CENTRAL VERMONT MEDICAL CENTER- CARDIOLOGY HEITZMAN MARK M.D. UNIVERSITY OF VERMONT MEDICAL CENTER- OTOLARYNGOLOGY HUBBELL RICHARD M.D. HUITT, JAMES PSY.D ISENBERG, GAIL PH.D. ITALIA, MICHAEL M.A. KELLOGG, ROGER M.D. KNAPP, CRAIG PH.D. KORGESKI, GREGORY- onsite review completed. PH.D. LANE EYE ASSOCIATES LEMAIRE-JENKINS, ELIZABETH LCMHC LYNCH, HEATHER M.A. MIDDLEBURY RADIOLOGISTS UNIVERSITY OF VERMONT MEDICAL CENTER- OTOLARYNGOLOGY MILLAY DONNA M.D. MAPLE LEAF CLINIC MOONEY DEAN PH.D. MORRISON, RICHARD M.D. NASH, PAMELA PSY.D NEEL, HARTLEY (RADIOLOGIST) M.D. NORTH COUNTRY HOSPITAL NORTHEASTERN VERMONT REGIONAL HOSPITAL NORTHWESTERN VERMONT MEDICAL CENTER PADILLA, TERRY LCMHC PORTER MEDICAL CENTER RADIOLOGY ASSOICATES OF BENNINGTON REDLINK, INC.- onsite review completed M.D. REICHARDT, DENNIS- onsite review completed PH.D. RICHMOND, BARBARA M.A. RICKARD, KATHRYN PSY.D ROOMET, ANDRES M.D. ROOT, RICHARD PH.D. ROSS, KATHLEEN SLP ROSS, PAUL M.D. ROSSMAN, FRED M.D. RUTLAND RADIOLOGISTS RUTLAND REGIONAL MEDICAL CENTER SEYFERTH, ERIC M.D. SITKOWSKI, SUZANNE PH.D. SOUTHWESTERN VERMONT MEDICAL CENTER SPRINGFIELD HOSPITAL UNIVERSITY OF VERMONT MEDICAL CENTER UVM RADIOLOGY

*no longer performing exams Key or Volume Provider- Korgeski, Redlink, and Reichardt were visited. In FY 16 Reichardt was a volume provider, so he was visited for an onsite review in anticipation he would be again, although he was the sixth highest volume provider. Onsite Review completed for interview/orientation Onsite Review completed for other reason Washington FY 2017

AARON D RUSSELL PSYD-EVERETT EVERETT AGNES S HUANG MD SEATTLE ALEXANDER L PATTERSON PSYD TACOMA ALICIA S FUHRMAN MD/AMCE-SEATTLE SEATTLE ALLEN D BOSTWICK PHD SPOKANE AMY FORD PSYD-ELLENSBURG ELLENSBURG Top provider - volume onsite reviews AMY L DOWELL MD/MDSI-YAKIMA YAKIMA AMY R ROSS PSYD TACOMA ANDREA A MARSHALL DO/MDSI-SEATTLE SEATTLE ANDREA J OPALENIK DO/MDSI-FEDERAL WAY FEDERAL WAY ANDREW PERRY MD EDMONDS ANDREW WEIR MD/MDSI-BELLINGHAM BELLINGHAM ANGELIQUE G TINDALL PHD/AMCE-SPOKANE SPOKANE ANJALI L DSOUZA MD-FEDERAL WAY FEDERAL WAY ANNA BORISOVSKAYA MD-FEDERAL WAY FEDERAL WAY ANNABELL K SIMPSON MD/MDSI-EVERETT EVERETT ANNE MARIE TIETJEN PHD BELLINGHAM ANSELM A PARLATORE MD-POULSBO POULSBO ANTHONY DIGIROLAMO DO/AMCE-SEATTLE SEATTLE APRIL M FRITCH PHD LAKEWOOD APRIL R DELIRA MD-TACOMA TACOMA ARID LEIN MD SPOKANE ARNOLD A RONNING MD/AMCE-AUBURN AUBURN ASHLEY D DAVIDSON MD-SEATTLE SEATTLE AUSTIN C LAMPERT MD OLYMPIA BARRY MORRISON PHD CANADA BEN JARAMILLO OD YAKIMA BENJAMIN C ALESHIRE PHD/MDSI-BELLINGHAM BELLINGHAM BENJAMIN N KARTCHNER MD/REDLINK LEWISTON BENJAMIN R DOBBECK PSYD/AMCE-LAKEWOOD LAKEWOOD BETH LIU MD LAKEWOOD BEVERLEY E ALLEN MD/MDSI-SPOKANE SPOKANE BEVERLY NORFLEET PSYD SEATTLE BEVERLY S SHAPIRO MD/QTC-TUKWILA TUKWILA BONNY W CHANG PHD/AMCE-AUBURN AUBURN BRENDA K HAVELLANA PHD LYNNWOOD BRENDON P SCHOLTZ PHD MARYSVILLE BRETT VALETTE PHD-TACOMA TACOMA Top provider - volume onsite reviews BRIGITTE M ENGELHARDT MD/MDSI-PORTLAND PORTLAND BRUCE DUTHIE PHD BREMERTON BRUCE J TAPPER PHD PORT TOWNSEND C MARK ANDERSON PHD/AMCE-CENTRALIA CENTRALIA CARA A DALBEY PSYD SNOQUALMIE CARA J ALEXANDER MD SEATTLE CARL EPP PHD-MT VERNON MOUNT VERNON CARL T RIMMELE PHD/AMCE-AUBURN AUBURN CARLA VAN DAM PHD TUMWATER CARRIE A ROLLER MD SPOKANE CARYN JACKSON MD YAKIMA CATHERINE A MACLENNAN PHD-OMAK OMAK CECILIA R COOPER PHD-PROSSER PROSSER CERISE M VABLAIS PHD KIRKLAND CHILDRENS DEVELOPMENTAL CENTER (BENTON-FRANKLIN) RICHLAND CHILDRENS VILLAGE CHILD HLTH SVCS YAKIMA CHRISTIAN M QUAYLE PHD-MILL CREEK MILL CREEK CHRISTINA H RASMUSSEN PHD UNIVERSITY PLACE CHRISTOPHER D JOHNSON OD WEST RICHLAND CHRISTOPHER H EDWARDS PSYD/AMCE-AUBURN AUBURN CHRISTOPHER J NELSON PHD BELLEVUE CLARK D ASHWORTH PHD COLVILLE COLLIN M BLATTNER DO/MDSI-PORTLAND PORTLAND CONSTANCE E MASH MD/MDSI-SPOKANE SPOKANE CORY R HANSEN OD WEST RICHLAND CYNTHIA L TAYLOR MD/AMCE-SEATTLE SEATTLE DALE HOLDREN MD BREMERTON DANA A COCKE OD TACOMA DANA JUNGSCHAFFER MD BREMERTON DANA S HARMON PHD SEATTLE DANIEL PHAN MD LYNNWOOD DARLENE E WALSH-MARTIN PHD SPOKANE DAVID B WIDLAN PHD SEATTLE DAVID BARRETT PHD-OCEAN SHORES OCEAN SHORES DAVID D MOORE PHD/ALLIED FEDERAL WAY DAVID G ZACHARIAS MD SEATTLE DAVID L POUNDS PHD SPOKANE DAVID M DIXON PHD KENT KENT DEBRA CIARLO MSPA CCC WENATCHEE DEBRA K MCKINNON DO/REDLINK LEWISTON DENNIS A KELLY PHD/AMCE-BELLINGHAM BELLINGHAM DENNIS G DYCK PHD/AMCE-SPOKANE SPOKANE DENNIS J HAACK MD/AMCE-SEATTLE SEATTLE DENNIS R POLLACK PHD SPOKANE DEREK J LEINENBACH MD/IMC-CENTRALIA CENTRALIA DIANA L COOK PHD-EVERETT EVERETT DOUGLAS R RICKS OD YAKIMA E ANDREA SHADRACH PSYD-REDMOND REDMOND EDWIN L HILL PHD TACOMA ELGA KINNEAR PSYD-ANACORTES ANACORTES ELIZABETH A HOLLAND PHD ANACORTES ELLEN WALKER PHD BELLINGHAM ELLIKA C MCGUIRE MD SEATTLE EMMA J BILLINGS PHD YAKIMA ERUM KHALEEQ MD/MDSI-LONGVIEW LONGVIEW FAULDER COLBY PHD EVERETT FRANCES L CARTER PHD/AMCE-BELLINGHAM BELLINGHAM GARY E GAFFIELD DO/AMCE-AUBURN AUBURN GARY GAFFIELD DO/MDSI-SEQUIM SEQUIM GARY MCGUFFIN PSYD-VANCOUVER VANCOUVER GARY SACKS PHD PORTLAND GENE O TEIGEN OD SPOKANE GEORGE ANKUTA PHD-BURIEN BURIEN GEORGE B SYMONDS OD PORT ANGELES GRANT O GILBERT PHD-SPOKANE SPOKANE GRANT W HARDAN OD SPOKANE GREG CHARBONEAU EDD (ERE) SPOKANE GREGORY A MAY PSYD VANCOUVER HARBOR SPEECH PATHOLOGY GIG HARBOR HEATHER E HOOPS MD/MDSI-PORTLAND PORTLAND HERBERT A YELVERTON PHD/AMCE-ELMA ELMA HOLLY S PETAJA PHD EVERETT IBRAHIM I KURDIEH PHD VANCOUVER IFESINACHI S OGUAKWA MD/MDSI-FEDERAL WAY FEDERAL WAY J KEITH PETERSON PHD TACOMA JACK M LITMAN PHD VANCOUVER JACKSON R HOLLAND MD OLYMPIA JACLYN A KNUTSON MA OLYMPIA JACLYN C RUSSELL MD/AMCE-SEATTLE SEATTLE JAI C GANDHI MD-FEDERAL WAY FEDERAL WAY JAIME AB WILSON PHD TACOMA JAMES A PARKER MD/MDSI-TUMWATER TUMWATER JAMES B GADDY MD/AMCE-SPOKANE SPOKANE JAMES DAVISON JR PHD/AMCE-BELLINGHAM BELLINGHAM JAMES K SYMONDS MD/QTC TUKWILA TUKWILA JAMES L BARLOW MD/MDSI-FEDERAL WAY FEDERAL WAY JAMES OPARA MD/MDSI-WALLA WALLA WALLA WALLA JANE C HAYWARD PSYD PUYALLUP JANIS L LEWIS PHD-PT ANGELES PORT ANGELES JANITZIA SCHURCH MD/PRO CARE-PT ANGELES PORT ANGELES JARED R HELLINGS PSYD EDMONDS JASON PRINSTER PHD BELLINGHAM JEFFERSON GEN HOSPITAL - XRAY PORT TOWNSEND JEFFREY R JAMISON DO/REDLINK-WALLA WALLA WALLA WALLA JENIFER F SCHULTZ PHD/AMCE-YAKIMA YAKIMA JENNIFER A IRWIN MD/MDSI-FEDERAL WAY FEDERAL WAY JENNIFER M GRONHOLT PSYD BELLINGHAM JENNY ZHANG MD/AMCE-SEATTLE SEATTLE JEREMY J SENSKE PSYD/AMCE-AUBURN AUBURN JESSICA VAN AUKEN CCC-A PORTLAND JOHN B SEVERINGHAUS PHD SPOKANE JOHN D ADLER PHD/MDSI-PORTLAND PORTLAND JOHN F ARNOLD PHD-SPOKANE VALLEY SPOKANE VALLEY JOHN H SCHWAB PHD SEATTLE JOHN JOK NHIAL HOBART JOHN R COE DO/QTC TACOMA TACOMA JONATHAN D ALLISON PSYD LAKEWOOD JOYCE EVERHART PHD SPOKANE JULIE A GUSTAFSON MD-EVERETT EVERETT JUSTIN D STAMSCHROR MD LYNNWOOD KAREN J WEST PSYD EDMONDS KATE K LUND PSYD EDMONDS KATHERINE J KELLY PHD RENTON KATHLEEN E REAN MD-FEDERAL WAY FEDERAL WAY KATHLEEN F GALLAGHER PHD/AMCE-CENTRALIA CENTRALIA KATIA H RAMIREZ PSYD SUMNER KATRINA L HIGGINS PSYD SUMNER KAY L STRADINGER PSYD/MDSI-PORTLAND PORTLAND KAYLEEN ISLAM-ZWART PHD SPOKANE KELVIN K MA MD PUYALLUP KENNETH A HAPKE PHD-SEATTLE SEATTLE KENTON S SORENSEN MD BREMERTON KERITH A TARANTINO PSYD/MDSI-SEATTLE SEATTLE KERRY T BARTLETT PHD BELLINGHAM KHANH P NGUYEN MD/MDSI-PORTLAND PORTLAND KIRSTEN R NESTLER MD/MDSI-BELLINGHAM BELLINGHAM LANDON E POPPLETON PHD VANCOUVER LENA K SWANSON PSYD OAK HARBOR LEWIS B ALMARAZ MD-SEATTLE SEATTLE LEZLIE A PICKETT PHD TACOMA LINDA JANSEN PHD RENTON LINDA LEE PSYD VANCOUVER LINDA NEWMAN-KENNEDY CCC-SLP ANACORTES LINDA R FELDTHAUSEN PHD/AMCE-CENTRALIA CENTRALIA LINDA R MEDESKI-NICACIO OD VANCOUVER LINDSEY M RUPPEL DO/REDLINK-WALLA WALLA WALLA WALLA LISA COWDEN PHD BURIEN LISA KOCH PHD SPOKANE LIZ A PECHOUS PHD SPOKANE LONGVIEW EYE AND VISION LONGVIEW LORELI A THOMPSON PHD LACEY LUCI L CARSTENS PHD MARYSVILLE LYNETTE J SCHULTZ PSYD SPOKANE LYNN M ORR PHD RICHLAND M KRISTIN PRICE PHD VANCOUVER MAJID AZZEDINE PHD FEDERAL WAY MANUEL J GOMES PHD/MDSI-PORTLAND PORTLAND MARC D FOWLER PSYD/AMCE-MARYSVILLE MARYSVILLE MARC I SUFFIS MD SILVERDALE MARGARET A DOLAN PHD-SEATTLE SEATTLE MARGARET D LUKOFF MD/MDSI-SEATTLE SEATTLE MARK D AGINSKY OD BELLINGHAM MARK HEILBRUNN MD-BELLINGHAM BELLINGHAM MARKUS L FORSYTHE MD/AMCE-VANCOUVER VANCOUVER MARVIN G PALMER MD KENNEWICK MARY C LEMBERG MD TACOMA MARY K COBURN SLP TUMWATER MELINDA C LOSEE PHD-LACEY LACEY MICHAEL A JENKINS-GUARNIERI PHD TACOMA MICHAEL A SLACK PSYD/AMCE-BELLINGHAM BELLINGHAM MICHAEL D MOORE OD OLYMPIA MICHAEL E KOSANOVICH TACOMA MICHAEL MILGROM MD CANADA MICHAEL WINGREN MD GIG HARBOR MICHELA L BLAIN MD-BELLEVUE BELLEVUE MIRIAM L ALAM MD-EVERETT EVERETT MONTY SMICK OD (ERE) SPOKANE MORGAN B LIDDELL MD/MDSI-COLVILLE COLVILLE MULTICARE PULMONARY AUBURN MULTICARE PULMONARY SPECIALISTS TACOMA NANCY C RUTTER SLP LYNNWOOD NATASHA T HAYS MD LACEY NATHAN D HENRY PSYD SPOKANE VALLEY NATHANIAL A SOWA MD-BELLEVUE BELLEVUE NEELAM K SAMPLEY MD/MDSI-BELLINGHAM BELLINGHAM NICKOLAS B JONES PHD SUMNER NORA K MARKS PHD-WALLA WALLA WALLA WALLA OWEN J BARGREEN PSYD EVERETT PAMELA G MILLER PHD THE DALLES PAMELA J MOSLIN-LYKINS MD/MDSI-FEDERAL WAY FEDERAL WAY PAMIL P SIDHU MD SPOKANE PATRICA R SYLWESTER MD/AMCE-CENTRALIA CENTRALIA PATRICK B METOYER PHD/AMCE-MOSES LAKE MOSES LAKE PAVEL S BLAGOV PHD WALLA WALLA PETER A WEISS PHD CHEHALIS PETER M MEIS MD-MILL CREEK MILL CREEK PETER N MOORE PSYD MILL CREEK PHILIP G BARNARD PHD RICHLAND PHILIP V GIBSON PHD/AMCE-BELLINGHAM BELLINGHAM PRESTON SULLIVAN MD-PT ORCHARD PORT ORCHARD PULMONARY CONSULTANTS TACOMA R DEAN RUSSELL MD OLYMPIA RAHUL KHURANA MD SEATTLE RAY JENSEN MD OLYMPIA REBECCA A SPECKMAN MD/AMCE-AUBURN AUBURN REBECCA J ALEXANDER PHD MOSCOW REGINA M HARRINGTON PHD/AMCE-BELLINGHAM BELLINGHAM REJOICE N OPARA MD-FEDERAL WAY FEDERAL WAY RENEE S THOMPSON PSYD CHEWELAH RICHARD E BENSINGER MD SEATTLE RICHARD W SEAMAN MD BREMERTON ROBBY C RIDDLE MD/MDSI-SPOKANE SPOKANE ROBERT G SISE MD TACOMA ROBERT J ROSE MD SPOKANE ROBERT L QUACKENBUSH PHD SPOKANE ROBIN H BALLARD PHD OLYMPIA ROCKWOOD PULMONARY & CRITICAL CARE SPOKANE RODERICK CALKINS PHD PORTLAND RONALD D NIELSEN MD/AMCE-CENTRALIA CENTRALIA RONALD D PAGE PHD WALLA WALLA RONALD J BENVENISTE MD TACOMA ROSE M SESSOMS MD/PRO CARE-MT VERNON MOUNT VERNON ROSEMARY I PIPER PHD/AMCE-MT VERNON MOUNT VERNON ROXANNE R MOORE PHD-BELLINGHAM BELLINGHAM RUSSELL W FARIA DO AUBURN RYAN G MASSOUD DO/REDLINK-MOSES LAKE MOSES LAKE SAMANTHA L SLAUGHTER PSYD SEATTLE SAMANTHA S CHANDLER PSYD SPOKANE SAMUEL E COOR DO LACEY SARAH A STEWART PHD/AMCE-OLYMPIA OLYMPIA SCOTT ALVORD PSYD-ABERDEEN ABERDEEN SETH T COPELAND OD YAKIMA SHANNON D LEDESMA PHD GIG HARBOR SHIRLEY R DEEM MD/MDSI-FEDERAL WAY FEDERAL WAY SIERRA L SWING PSYD SEATTLE STEPHANIE G HANSON PHD LAKEWOOD STEPHANIE K CHANG MD-MILL CREEK MILL CREEK STEPHEN L WALSTON MD-BELLEVUE BELLEVUE STEPHEN MEHARG PHD LONGVIEW STEVEN J TALMADGE PHD OAK HARBOR STEVEN S RODE DO/MDSI-RICHLAND RICHLAND SUNG-WON KIM MD OLYMPIA SUSAN STEWART MS CCC-SLP LYNNWOOD SUSHIL M SETHI MD VANCOUVER SYLVIA A THORPE PHD BELLINGHAM TERILEE WINGATE PHD LACEY THE ACHIEVE CENTER-WENATCHEE WENATCHEE THOMAS B ROWE PHD WENATCHEE THOMAS GENTHE PHD SPOKANE TOBIAS A RYAN PSYD VANCOUVER TODD D BOWERLY PHD VANCOUVER TOM DOOLEY PSYD-VANCOUVER VANCOUVER TOVA F FULLER MD-MILL CREEK MILL CREEK TREVOR P GESSEL MD/MDSI-SEATTLE SEATTLE UCHECHUKWU OBIH MD/AMCE-AUBURN AUBURN VANESSA G DZIVAKWE PHD/AMCE-SEATTLE SEATTLE VANESSA S MAYCUMBER MD/OLYMPUS-CLARKSTON CLARKSTON W DANIEL DAVENPORT MD/AMCE-ELMA ELMA W MICHAEL ROGERS PSYD/AMCE-OLYMPIA OLYMPIA WALTER HORAN AUD WENATCHEE WILLIAM B GUNDERSON MD FRIDAY HARBOR WILLIAM J CHALSTROM PHD-PT ORCHARD PORT ORCHARD WILLIAM JACKLINE EDD SPOKANE WILLIAM R DRENGUIS MD/AMCE-KENNEWICK KENNEWICK WILLIAM U WEISS PHD VANCOUVER WING C CHAU MD RICHLAND YAKIMA VALLEY HEARING & SPEECH CENTER YAKIMA YUN-JU CHENG PHD/AMCE-POULSBO POULSBO MDSI - multiple vendors Top Provider-Primary CEs onsite reviews AMCE - multiple vendors Top Provider-Primary CEs onsite reviews QTC - multiple vendors Top Provider - Primary CEs onsite reviews Wisconsin FY 2017

Inactive due to: Key Provider/ Individual CE Providers Inactive Inactive license (L), Quality (Q), Sanction Site Visit (S) AARON S WHITNEY PHD ABDUL HAFEEZ MD Volume Provider (dba Columbia St. Mary's Westgate) Yes ABIGAIL L ROTH OT/SP ABIGAIL LEWIS MD ADRIANA NEWTON OT ALBERT FISHER MD ALEJANDRO ARANDA MS CCC-SLP ALEXIA PRINTZ MS CCC-SLP ALYSON ROGERS MS CCC-SLP AMANDA HOUDEK MS CCC-SLP- 3 Sites AMY HOFKES OT AMY M MOSCHELL MD AMY SORENSEN DO ANDRA M SCHMIDT OT ANDREW J WRIGHT MD ANGIE HOLTSKI OT Primary/Volume/Top 5 Provider A. NEIL JOHNSON MD- 9 Sites Yes (2 Sites) ANN VAN BUREN SLP- 2 Sites ANNETTE VIELLEUX PSYD ANTHONY R ROGERSON MD ANTHONY WENDORF PSYD- 6 Sites Primary/Volume/New Site (dba Solutions for Success) Provider Yes APRIL D SMITH OD ASHLEY BEECROFT OT BARBARA BLANK OT BECCA GREUB PHD- 2 Sites BENJAMIN BLAGOGEE MD- 3 Sites BENJAMIN DELLARIA MD BETH GABAVICS AUDIOLOGIST BETHANY CARLSON MS CCC-SLP Primary Provider BONNIE BEHEE-SEMLER PHD Yes BRE ANNA NAGLE MD Inactive NA BREANA GALEAZZI MS CCC-SLP- 2 Sites BRENDA REED PSYD BRIAN CHAPMAN MD BRIAN K ALLEN DO- 4 Sites BRIAN SIECK MD BRIAN TIENOR MD Inactive NA BRUCE C HERMAN MD BRUCE H HOUTLER OT BRYAN L MYERS MD BRYAN ROBERTS MD CALLIE ENYART OD- 2 Sites Inactive NA CALLIE S EHMCKE MS CCC-SLP CAMIE WHEELER AUDIOLOGIST Primary Provider CATHERINE A BARD PSYD- 3 Sites Yes CHAPMAN LEFFINGWELL OD CHERYL PETRUS OT Inactive NA CHRISTINE RICHARDS MD CHRISTOPHER R OVIDE EDD CLARE RUIDL OT

CLAUDIA BODWAY PHD Inactive NA (dba WellCare Disability, NuCare Disability) CORNELIA A GREEN PHD

COURTNEY ENDRES PSYD (dba WellCare Disability, NuCare Disability) CRAIG W FLORINE MD D EVAN BESTLAND PHD DANA A TRUTTMANN AUDIOLOGIST DANIEL STOPPENBACH AUDIOLOGIST Primary Provider DARRELL L HISCHKE PHD Yes Primary Provider DARYL J MELZER MD (dba Mobilex) No DAVE NICHOLS PHD Volume Provider (dba Psychiatric Services of Racine) Yes DAVID MAY MD DAVID W GRAMBOW MD DEAN B SANER PSYD- 2 Sites DEBORAH K SCHERMER MS CCC-SLP DENNIS ELMERGREEN PSY D DENNIS J KONTRA MD

DHARAM JAIN MD Primary/New Provider (dba WellCare Disability, NuCare Disability) Yes DIANE GERLACH DO DOUGLAS M SOAT PHD E OVERHOLT MD ELIZABETH JENNINGS PHD ERIC CARLSEN MD ERIK GRAGLIA OT FRANK J ELMUDESI PSYD- 2 Sites GLEN KOHLHAGEN OD GORDON HERZ PHD GREGORY COWAN PHD GREGORY LEISCHER OD GREGORY LOCHEN MD GRETCHEN M ADAMS DO Inactive NA IRIS TORRES MD JACLYN MULLINS MD Inactive NA JAMES DICKMAN III MD JAMES GERAETS OD JAMES MARTIN MD JAMES MATHEW MD JANET PAPENFUSS MS CCC-SLP JAY ALLEN PHD JAYNE E JASKOLSKI PHD CCC-SLP JEAN WARRIOR PHD JEFFREY BROWN MD JEFFREY L POLCZINSKI PSYD JEFFREY SARAZEN OD JENNA SEBRANEK MD JENNIFER MYSZKOWSKI MD JENNIFER PLOCH AUD Inactive NA JEREMY D MEYERS EDD JESSE J FREY PSYD- 2 Sites JESSICA LEMKE MD Inactive NA JILL M DILLON OD JILLIAN SCHERER MD JOAN R NUTTALL PHD JOANNE FINK MS CCC-SLP JOANNE PICKETT OT JOHN D RIESCH MD JOHN HENNINGSEN MD JOHN JUERN PHD- 2 Sites JOHN P FREY MD JOSEPH F ROE PSYD JOSEPH T PERRON PHD- 2 Sites JOSHUA LIBERMAN MD JUDITH B CORAN MD JUDY WARNKE OT JUI HAKER MD- 2 Sites JULIE FRAZIER MS CCC-SLP JULIE K BYRNES MS CCC-SLP JULIE KESSLER AUD Inactive NA JULIETTE KOEPP MS CCC-SLP- 3 Sites KALPANA RAO PHD Primary/Volume Provider (dba Horizons Behavioral Health Solutions) Yes KAMAL SYED MUZAFFAR MD KAREN BERTE PHD- 2 Sites KAREN BUTLER MD Inactive NA KAREN K KULLA MS CCC-SLP KAREN TETER, AUDIOLOGIST KATE WASECHEK OT KATHLEEN A CLARKE PHD KATHLEEN M HAASCH AUDIOLOGIST KATHY MARSCEAU MS CCC-SLP KATIE BETRY OT- 2 Sites KAUSERUZZAMAN KHAN MD KELLY L SCHULTZ AUDIOLOGIST KELLY SCHINKE PSYD KELSEY KOERNER OD KELSEY MEALEY MS CCC-SLP KENNETH E SHERRY PHD KENT SCHAEFER MD KEVIN ROONEY PSYD KEVIN ROSTEING MD KIMBERLY SCHWABENBAUER MS CCC-SLP KIRA L FEMRITE MS CCC-SLP KIRSTEN GIERACH DO Inactive NA KRISSI DANIELSSON MD (dba Prevea Eau Claire Health Center) KRISSI DANIELSSON MD- 2 Sites Primary Provider (dba CE Provider Services) Yes KRISTEN GERKE MA CCC-SLP KRISTEN SISKOVICH SLP Inactive NA KRISTEN WRIGHT SLP Inactive NA KRISTIE SHAPPELL MD KRISTIN NYTES/AUDIOLOGIST KURT L REINTJES MD- 5 Sites Primary/Volume/Top 5 Provider (dba Sagebrush LLC) Yes KURT WEBER PHD- 5 Sites Primary Provider (dba Hope Psychological Services LLC) Yes LATOYA WILLIAMS PSYD

LAUREN NATZKE-BLUME MS CCC-SLP- 2 Sites LAUREN SAUTER MD Inactive NA LEE PURDY OD LESLEY CHAPIN PSYD LESLIE L BENNETT MS CCC-SLP/MD LINDA J BARBIAN AUDIOLOGIST LINDA WUNDERLICH AUDIOLOGIST LINDSEY SCHINDLER DO LISA WEBNE-BEHRMAN PHD Inactive NA LISBETH HEILMANN MS CCC-SLP LONNI BRICKSON OT Inactive NA MARA JONET MA CCC-SLP- 2 Sites MARC W ZYLSTRA PHD Primary/Volume Provider MARCUS DESMONDE PSYD- 4 Sites Yes MARIA CHIRONIS MS CCC-SLP- 2 Sites MARIA E PEREZ PHD MARIBETH SADIE PHD Volume Provider (dba Psychiatric Services of Racine) No MARIE HARPER MS CCC-SLP- 2 Sites MARIE MILLER-CHRISTENSEN PSYD MARILYN BEFERA-ZIELINSKI PHD Volume Provider (dba Psychiatric Services of Racine) Yes MARJORIE C HAWKINS MD MARK C AUSTIN MD MARK C RHODES MD MARK L MARTIN DO Primary/Volume Provider MARK PUSHKASH PHD Yes MARK W SNEED MD MARLIN O TRULSEN PHD MARY B LAW PSYD MARY KAY LUZI PHD MARY L THORPE MS CCC-SLP MARY LOKKEN OT MASROOR MUNIM MD MATTHEW E BETTAG MD MATTHEW L NELSON OD MATTHEW SDANO MD MAURA J MOYLE MS CCC-SLP MAX MELBERG OD- 2 Sites MCKENZIE HOFFMAN MA CCC-SLP- 2 Sites MEENAKSHI MASKI MD MEGAN KENNEDY MA CCC-SLP MEGAN REIMER MS CCC-SLP MEGAN WISNIEWSKI OT- 2 Sites MELISSA PLUTZ SLP Inactive NA MELISSA WEGNER SLP- 2 Sites Inactive NA MICHAEL ALBANO DO MICHAEL ALEKSANDROWICZ MD Inactive NA MICHAEL BRAUNSKY DO Inactive NA MICHAEL CASE MD MICHAEL D GOLDSTEIN PHD MICHAEL E BECKER MD MICHAEL G OLACIREGUI MD MICHAEL MCAVOY DO MICHAEL OTTE MD Inactive NA MICHAEL R DAWSON MD MICHAEL R DAWSON MD Inactive NA MICHAEL SCHULTZ AUDIOLOGIST MICHELE BROWN OT Inactive NA MILT SCHMIDA AUDIOLOGIST MOHAMMAD N FAREED MD Volume Provider (dba Columbia St. Mary's Westgate) Yes MONICA HAUT MS CCC-SLP MONICA STOUT MD NATALIE ALTENHOFEN SLP Primary Provider NEAL H POLLACK DO (dba Mobilex) Yes NEIL BARD MD NICHOLAS GLASS MD- 3 Sites (dba Allied Medical Services) Volume Provider NICHOLAS GLASS MD (dba Med Plus) Yes NICKOLAS T SGARLATA MS CCC-SLP NICOLE LEE MS CCC-SLP NICOLE NICHOLS MA CCC-SLP/SP NORAH C GARRITY MS CCC-SLP- 2 Sites OMUWA BRAIMAH MD PAMELA BENEDICT AUDIOLOGIST PATRICIA L BROMLEY PHD PATTI L TODD, AUDIOLOGIST PAUL E WEST PHD PAUL F DVORAK MD PAUL K THOMPSON OD PAUL STASKOWSKI MD PEGGY DENNISON PHD PETER HOLM MD PETER KORES EDD- 2 Sites PETER M IHLE MD R R FLICKINGER MD RACHEL J BUTALLA SLP RACHEL SCANNELL MS CCC-SLP RACHELLE EUGSTER MA CCC-SLP- 2 Sites REBECCA D AMARAL OD REBECCA FLEGNER PSYD REBECCA L ANGLE PHD RENEE REETZ MS CCC-SLP RICHARD ALTHOUSE PHD RICHARD BRIGHAM PSYD RICHARD D DAVENPORT MD RICHARD J ERTL PHD RICHARD N COCKER MS LP ROBERT B ROTH MD ROBERT J GOGAN MD ROBERT L MEYER PHD ROBERT L ZOELLER JR MD ROBERT S JUNE AUDIOLOGIST ROBERT STUBENVOLL MD Inactive NA ROBERT VERWERT PHD- 2 Sites ROBIE JO LINN MA CCC-SLP ROGER C GRONAU PHD- 2 Sites ROGER J KLEIN PSYD Primary/Volume Provider ROLAND W MANOS PHD- 2 Sites Yes RONALD B JOHNSON PHD- 2 Sites RUTH MEEHAN OT RYAN HUMMEL AUDIOLOGIST SADIE A BOGNAR MS CCC-SLP- 3 Sites SAKINA SACHAK MD Inactive NA (dba Prevea Eau Claire Health Center) SAKINA SACHAK MD- 2 Sites (dba CE Provider Services) SALLY A ANDERSEN CCC-SLP SAM KUCHINKA MD SANDRA JOHNSTON OT SANDRA L FRODIN PHD SANDRA L KING PHD SARAH B WILLIAMS SLP- 2 Sites Inactive NA SARAH L CLEMENT MA CCC-SLP/SP SARAH VAN DUINEN MA CCC-SLP- 3 Sites SCOTT TRIPPE PSYD SEAN PETERSON OT SHAHIDA R MUNIM MD SHERYL DOLEZAL PSYD STACEE GOEDTEL BIRR DO Inactive NA STACEY E SOELDNER PSYD STEVEN BENISH PHD STEVEN J MILLEN MD SC Primary/Volume/Top 5 Provider STEVEN KRAWIEC PHD- 3 Sites Yes STEVEN L NOTTLESON OD STEVEN SHIRCEL OD STEVEN VANDENBERG MD STUART J WALTONEN PHD SUE CAVALLIN MA CCC-SLP SUSAN CARLIN MS CCC-SLP SUSAN DE ZEEUW OT TAMMY ZIMMEL PSYD TED MOLLERUD AUDIOLOGIST TERRENCE MCCANNA MD TERRY KADDATZ PSYD THAO NGUYEN TRAN MD THOMAS J LEONARD MD Inactive NA THOMAS J MORAN PHD THOMAS J SPEECH PHD THOMAS RICHARDSON MD Primary/Volume/Top 5 Provider THOMAS S LEHMANN PHD- 2 Sites Yes (dba Life-Span Psychological Services INC) THOMAS SCRENOCK MD TIMOTHY LAUGHLIN PHD TIMOTHY VAN DER PERREN MS CCC-SLP TODD VERDON OD TRACY RADKE OT Not a Primary Provider TRAVIS W HINZE PHD- 3 Sites Yes VICTOR S SLANA MD Primary Provider WARD JANKUS MD- 4 Sites Yes WEI-CHUAN WANG MD Inactive NA WENDY J CLARK MS CCC-SLP WENDY REGAN, AUDIOLOGIST WILLIAM L CAMP PHD WILLIAM W FINCH MD

Medical Facilities Performing Ancillary Testing ASPIRUS MEDFORD HOSPITAL & CLINICS AURORA MEDICAL CENTER HARTFORD AURORA SINAI MEDICAL CENTER MILWAUKEE- 2 Sites BAY AREA MEDICAL CENTER MARINETTE BEAVER DAM COMMUNITY HOSPITAL BELLIN HEALTH ALGOMA BELOIT MEMORIAL HOSPITAL BOSCOBEL AREA HEALTH CARE BURNETT MEDICAL CENTER COLUMBIA ST MARYS MILWAUKEE CUMBERLAND MEMORIAL HOSPITAL DEAN MED CENTER MADISON

DIVINE SAVIOR HEALTHCARE INC PORTAGE DOOR COUNTY MEMORIAL HOSPITAL EAU CLAIRE FAMILY MEDICINE Inactive NA EAU CLAIRE HEART CARE EDGERTON HOSPITAL EYE & VISION CLINICS SC DE PERE

FAMILY RESOURCES ASSOCIATES WATERTOWN FROEDTERT MEMORIAL LUTHERAN HOSPITAL MILWAUKEE

GRANT REGIONAL HEALTH CTR LANCASTER GREENFIELD REHAB GUNDERSEN LUTHERAN MEDICAL CENTER LA CROSSE HAYWARD AREA MEMORIAL HOSPITAL HEALTHREACH REHABILITATION SERVICES INC BROOKFIELD HOLY FAMILY MEMORIAL MEDICAL CENTER MANITOWOC HOWARD YOUNG MEDICAL CENTER

INDIANHEAD MEDICAL CENTER SHELL LAKE LAKELAND MEDICAL CENTER ELKHORN LAKEVIEW MEDICAL CNTR RICE LAKE LANGLADE HOSPITAL ANTIGO MARSHFIELD CENTER

MAYO CLINIC HEALTH SYSTEM NORTHLAND MAYO CLINIC HEALTH SYSTEM RED CEDAR MAYO CLINIC-FRANCISCAN HEALTHCARE LA CROSSE MEMORIAL HOSP OF LAFAYETTE COUNTY DARLINGTON MEMORIAL MEDICAL CENTER ASHLAND MERCY ASSISTED CARE JANESVILLE MERCY HOSPITAL JANESVILLE MERCY MEDICAL CENTER OSHKOSH MERITER HOSPITAL INC MADISON MILE BLUFF MEDICAL CENTER MAUSTON MONROE CLINIC

NEUROLOGY OF BELLIN HEALTH GREEN BAY OUR LADY OF VICTORY HOSPITAL STANLEY RICHLAND MEDICAL CENTER LTD RICHLAND CENTER RIVERVIEW HOSPITAL WISCONSIN RAPIDS

RUSK CO MEMORIAL HOSPITAL LADYSMITH SACRED HEART HOSPITAL EAU CLAIRE SACRED HEART HOSPITAL TOMAHAWK SHEBOYGAN CLINIC SHEBOYGAN MEMORIAL MEDICAL CTR SHELL LAKE CLINIC ST AGNES HOSPITAL FOND DU LAC ST CLARE HOSPITAL BARABOO ST CROIX REGIONAL MEDICAL CENTER ST CROIX FALLS ST ELIZABETH HOSPITAL APPLETON ST FRANCIS HOSPITAL MILWAUKEE

ST JOSEPH COMMUNITY HOSPITAL WEST BEND ST JOSEPHS HOSPITAL MILWAUKEE ST JOSEPHS HOSPITAL CHIPPEWA FALLS ST LUKES MEDICAL CENTER MILWAUKEE ST MARYS DULUTH CLINIC ST MARYS HOSPITAL DULUTH ST MARYS HOSPITAL GREEN BAY ST MARY'S HOSPITAL OF SUPERIOR ST MARYS HOSPITAL MADISON ST MARYS HOSPITAL RACINE ST MARYS HOSPITAL RHINELANDER ST MARYS MEDICAL CENTER RACINE ST MICHAELS HOSPITAL STEVENS POINT ST VINCENT HOSPITAL GREEN BAY THEDACARE APPLETON THEDACARE NEENAH THEDACARE SHAWANO THEDACARE WILD ROSE THEDCARE BERLIN TOMAH MEMORIAL HOSPITAL

UNITED HOSPITAL SYSTEM KENOSHA CAMPUS UW HOSPITAL MADISON WATERTOWN REGIONAL MEDICAL CENTER WAUKESHA MEMORIAL HOSPITAL INC WAUSAU HOSPITAL WEST ALLIS MEMORIAL HOSPITAL

WINONA COMMUNITY MEMORIAL HOSPITAL WISCONSIN CARDIOVASCULAR GROUP MILWAUKEE West Virginia FY 2017 VENDOR CREDENTIALING

VENDOR INFORMATION State Licensing Verification Onsite Reviews Statement DDS License License OIG & License OIG & Onsite Key Removed Provider's of License PRO Vendor Phone # FEIN # Expiration Verification SAMS Verification SAMS Review Provider from DDS Comments Vendor Name & Specialty Agreement Number Initials ID # Date Date Check Date Check Date (Y/N) CE Panel Address Date Charleston Vendor Credentialing: Access Vision--Gomez, David (b) (6) (b) (6) 1623 Robert C Byrd Drive (b) (6) (b) (6) Beckley, WV 25801 256-3937 OD July-19 6/30/18 12/1/16 12/1/16 7/12/17 6/22/17 5/11/2017 N N Appalachian Hearing & Balance 1242 Hockman Pike Bluefield, VA 24605 276-326-3890 ↓ ↓ ↓ ↓ ↓ ↓↓10/18/2016 N N Appalachian Hearing & Balance-- Larsen, William 276-326-3890 Audio Aug-19 12/31/18 12/1/16 12/1/16 1/17/17 6/22/17 "" "

Appalachian Hearing & Balance-- Rhodes, Cheryl 276-326-3890 Audio Aug-19 12/31/18 12/1/16 12/1/16 1/17/17 6/22/17 "" " Aspire Occupational Rehabilitation 88 Michigan Ave Smithers, WV 25186 855-5886 ↓ ↓ ↓ ↓ ↓ ↓↓3/8/2017 Y N Aspire Occupational Rehabilitation 440 South Main St (b) (6) Chapmanville, WV 25508 855-5886 ↓ ↓ ↓ ↓ ↓ ↓↓12/21/2016 Y N Aspire Occupational Rehabilitation 400 Allen Dr Ste 401 Charleston, WV 25302 855-5886 ↓ ↓ ↓ ↓ ↓ ↓↓7/19/2017 Y N Aspire Occupational Rehabilitation 9 Yellow Wood Way Beckley, WV 25801 855-5886 ↓ ↓ ↓ ↓ ↓ ↓↓6/2/2017 Y N Aspire Occupational Rehabilitation 194 Pinnell St Bldg 7 Ripley, WV 25271 372-8989 ↓ ↓ ↓ ↓ ↓ ↓↓7/11/2017 Y N Aspire Occupational Rehabilitation 1001 6th Ave Suite 5 Huntington, WV 25701 720-0396 ↓ ↓ ↓ ↓ ↓ ↓↓7/3/2017 Y N

Aspire--Gettman-Hughes, Kara ↑ MA Feb-18 6/30/18 12/1/16 12/1/16 6/22/17 6/22/17 "Y

New To Panel New Added (b) (6) Aspire--Henline, Melinda ↑ MA June-19 3/31/19 Added 7/5/17 7/5/17 7/5/17 7/5/17 ""

Aspire--Null, Angela ↑ MS Feb-18 12/31/17 12/1/16 12/1/16 6/22/17 6/22/17 "Y

Aspire--Sargent, Lester ↑ MA Feb-18 9/30/19 12/1/16 12/1/16 9/27/17 6/22/17 "Y

Aspire--Smith, Nicole ↑ MA Feb-18 6/30/18 12/1/16 12/1/16 6/22/17 6/22/17 "Y Assessments--Bell, Sunny 300 North Kanawha St Beckley, WV 25801 763-8186 MA Feb-18 3/31/19 12/1/16 12/1/16 3/13/17 6/22/17 1/26/2017 N N Assessments--Bell, Sunny 204 Howard Ave Mullens, WV 25882 294-5150 MA Feb-18 3/31/19 12/1/16 12/1/16 3/13/17 6/22/17 10/12/2016 N N Beckley ARH: Speech & Language 306 Stanaford Rd Beckley, WV 25801 255-3366 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/7/2017 N N VENDOR CREDENTIALING

Beckley ARH: Speech & Language-- New To Panel New Added Fitzpatrick, Joanna 255-3366 SLP June-19 12/31/18 Added 6/6/17 6/6/17 6/6/17 6/6/17 "" "

Beckley ARH: Speech & Language-- Sites, Hannah Rae 255-3366 SLP Mar-19 12/31/18 1/3/17 12/1/16 6/27/17 6/27/17 "" " Bodkin, Elizabeth A 90 Howard St (McDowell Co Library Welch, WV 24801 (b) (6) MA Jan-18 6/30/19 12/1/16 12/1/16 6/8/17 6/27/17 6/6/2017 N N Bodkin, Elizabeth A (b) (6) Logan, WV 25601 (b) (6) MA Jan-18 6/30/19 12/1/16 12/1/16 6/8/17 6/27/17 5/24/2017 N N Browning Eye Care--Browning, Gregory, 912 Oak Street Kenova, WV 25530 453-4072 OD July-19 6/30/18 12/1/16 12/1/16 7/13/17 6/27/17 11/2/2016 N N Cabell Huntington Family Med Ctr-- Collins, Nathaniel, 750 Oak St New To Panel New Added Kenova, WV 25530 453-6136 APRN July-19 6/30/19 Added 7/28/17 7/28/17 5/15/17 5/15/17 7/27/2017 N y Clay County Health Dept-- Brown, Angela, 261 Main St (b) (6) Clay, WV 25043 587-4269 APRN May-19 6/30/19 5/15/17 05/15/17 5/15/17 9/27/17 6/14/2017 N N Dagher, Ghassan 401 6th Ave Ste 110 Montgomery, WV 25136 442-8076 MD-Opth July-19 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 5/9/2017 N N Ear Nose & Throat Assoc Of Chas 500 Donnally St Ste 200 (b) (6) Charleston, WV 25301 340-2200 ↓ ↓ ↓ ↓ ↓ ↓↓8/1/2017 N N Ear Nose & Throat Assoc Of Chas-- Beasley, Michael Scott ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 "N N

Ear Nose & Throat Assoc Of Chas-- Dawson, G Stephen ↑ MD Feb-18 6/30/18 12/7/16 12/1/16 6/27/17 6/27/17 "" "

Ear Nose & Throat Assoc Of Chas-- Goins, Michael ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 "" "

Ear Nose & Throat Assoc Of Chas-- Lough, David ↑ MD Feb-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 "" "

Ear Nose & Throat Assoc Of Chas-- Nichols, Phillip ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/28/17 6/27/17 "" "

Ear Nose & Throat Assoc Of Chas-- Phillips, David ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/22/17 6/27/17 "" "

Ear Nose & Throat Assoc Of Chas-- Sporck, Frederick ↑ MD Feb-18 6/30/19 12/1/16 12/1/16 6/27/17 6/27/17 "" " Fields, Melinda (b) (6) Bluefield, WV 24701 (b) (6) PHD Jan-18 6/30/18 12/6/16 12/1/16 6/27/17 6/27/17 12/5/2016 N N Greenbrier Audiology Inc 150 Dawkins Dr Lewisburg, WV 24901 647-4327 ↓ ↓ ↓ ↓ ↓ ↓↓3/29/2017 N N Greenbrier Audiology Inc 2216 S Kanawha St Beckley, WV 25801 255-6310 ↓ ↓ ↓ ↓ ↓ ↓↓7/20/2017 N N VENDOR CREDENTIALING

Greenbrier Audiology--Stout, Laura ↑ Audio Feb-18 12/31/18 1/4/17 12/1/16 6/27/17 6/27/17 "" " Hasan Medical Inc 224 Professional Park (b) (6) Beckley, WV 25801 255-9444 ↓ ↓ ↓ ↓ ↓ ↓↓1/31/2017 N N Hasan Medical Inc-- Hassan, Surayia 255-9444 MD Nov-18 6/30/18 12/1/16 12/1/16 6/27/17 6/27/17 1/31/2017 N N

Hasan Medical Inc-- Wasylyk, Irene 255-9444 MD Nov-18 6/30/19 12/1/16 12/1/16 6/7/17 6/27/17 1/31/2017 N N Holley, Robert M (b) (6) (b) (6) (b) (6) Point Pleasant, WV 25550 MD Feb-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 1/11/2017 N Y Hosman, Steven (b) (6) Charleston, WV 25301 (b) (6) OD Feb-18 6/30/18 12/2/16 12/2/16 7/7/17 6/27/17 8/16/2017 N N Huntington ENT Specialists--Touma B. Joseph 5170 US Rt 60 East Huntington, WV 25705 522-8800 MD Dec-18 6/30/19 12/2/16 12/2/16 7/7/17 6/27/17 10/25/2016 N N Jennings, Elizabeth (b) (6) (b) (6) Bluefield, WV 24701 (b) (6) MA May-19 9/30/19 12/2/16 12/2/16 9/27/17 6/27/17 11/21/2016 N N Jewell, Karen (b) (6) Hurricane, WV 25526 (b) (6) APRN July-19 6/30/19 6/28/17 6/28/17 9/27/17 6/28/17 9/30/2017 N N Jones-Wheeler, Misti (b) (6) Oak Hill, WV 25901 (b) (6) MA Jan-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 6/28/2017 N N Katrib, A Karim 400 Division St Ste 12 South Charleston, WV 25309 (b) (6) ENT Aug-19 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 1/5/2017 N N Katrib, A Karim (b) (6) Logan, WV 25601 (b) (6) ENT Aug-19 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 3/10/2017 N N Key Care--Rago, Andres Removed HC 52 Box 135 Main St Removed From From CE Keystone, WV 24852 862-4611 MD Feb-18 6/30/17 12/2/16 12/2/16 CE Panel Panel n/a N Y Kid Care Pediatrics--Darnell, Robin (b) (6) 4407 MacCorkle Ave 2nd Floor Charleston, WV 25304 925-0392 MD Nov-18 6/30/18 12/2/16 12/2/16 6/27/17 6/27/17 8/24/2027 N N Legg, Larry (SRMC Specialty Clinic) 702 Professional Park Dr Ste 106 Summersville, WV 26651 883-2380 MA Sep-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 1/23/2017 N N Legg, Larry (Clay County Health Dept) N H Dyer Medical Facility Main St Clay, WV 25043 587-4269 MA Sep-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 7/14/2017 N N Lindsey Optical Inc 310 Locust St Ste 6 Princeton, WV 24740 487-2020 ↓ ↓ ↓ ↓ ↓ ↓↓3/21/2017 N N

Lindsey Optical--Carpenter, Scott 487-2020 OD July-19 6/30/18 12/2/16 12/2/16 6/29/17 6/27/17 "N N

Lindsey Optical-- Cole, Kenneth 487-2020 OD July-19 6/30/18 12/2/16 12/2/16 6/29/17 6/27/17 "N N VENDOR CREDENTIALING

Milestones Physical Therapy--Blake, Julie 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " "

Milestones Physical Therapy-- Burdette, Erica 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " "

Milestones Physical Therapy-- Casto, Lacie 760-6300 SLP Nov-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " "

Milestones Physical Therapy--Cole, Joy 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " "

Milestones Physical Therapy-- Runyan, Jenna 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " "

Milestones Physical Therapy-- Shaffer, Linsey 760-6300 SLP Feb-18 12/31/18 1/19/17 12/2/16 6/27/17 6/27/17 "" " " Mountain State ENT & Facial Plastic 84 Brookshire Lane Beckley, WV 25801 255-2341 ↓ ↓ ↓ ↓ ↓ ↓↓6/22/2017 N N Mountain State ENT & Facial Plastic Paine Jr, Albert 255-2341 MD Dec-18 6/30/19 12/2/16 12/2/16 6/7/17 6/27/17 "N N

Mountain State ENT & Facial Plastic Ziolkowski, Lori 255-2341 Audio Dec-18 12/31/18 1/17/17 12/2/16 6/27/17 6/27/17 "N N PAIS:Charleston--Robinson, Kelly 4834 MacCorkle Ave SW South Charleston, WV 25309 800-998-7596 MA Mar-19 12/31/17 12/2/16 12/2/16 6/27/17 6/27/17 9/8/2017 Y N PAIS:Beckley 330 Harper Park Rd Suite I Beckley, WV 25801 415-1500 ↑ ↑ ↑ ↑ ↑ ↑↑7/18/2017 Y N PAIS:Barboursville 6351 US Route 60 East Suite 8 Barboursville, WV 25504 800-998-7596 ↑ ↑ ↑ ↑ ↑ ↑↑5/25/2017 Y N VENDOR CREDENTIALING

Pleasant Valley Hospital: Speech-- Vaughan, Pamela 675-8639 SLP Aug-19 12/31/18 1/9/17 12/5/16 6/27/17 6/27/17 "" " Psychological Associates of Logan-- Glick, Angela 306 Main St, Logan, WV 25601 752-7707 MA July-18 12/31/18 12/6/16 12/5/16 6/27/17 6/27/17 4/11/2017 N N Psychological Testing Services-- Jarrell, Teresa 114 W Main St Keystone, WV 24852 323-1627 MA Jan-18 12/31/18 12/5/16 12/5/16 6/27/17 6/27/17 4/11/2017 N N Psyscape Inc--Vecchio, Ernie 201 6th Ave (b) (6) St Albans, WV 25177 552-9832 MA May-17 9/30/17 12/5/16 12/5/16 Retired Retired 2/27/2017 N Y River Valley Associates 2828 1st Ave Ste 203 Huntington, WV 25702 302-2467 ↓ ↓ ↓ ↓ ↓ ↓↓12/12/2016 N N River Valley Associates-- Chaney, Mary 302-2467 MA Feb-18 9/30/18 12/5/16 12/5/16 6/27/17 6/27/17 "" "

River Valley Associates-- Wilson, Emily Engelland 302-2467 MA Feb-18 12/31/18 12/5/16 12/5/16 6/27/17 6/27/17 "" " Roberson Orthopedic Clinic 3009 Jackson Ave (b) (6) Point Pleasant, WV 25550 675-8095 ↓ ↓ ↓ ↓ ↓ ↓↓5/17/2017 N Y Roberson Orthopedic Clinic-- Roberson, Clifford 675-8095 MD May-18 6/30/19 12/5/16 12/5/16 6/22/17 6/27/17 "" " " Simmerman Hearing & Speech 20 Hospital Drive Logan, WV 25601 344-4400 ↓ ↓ ↓ ↓ ↓ ↓↓4/14/2017 N N Simmerman Hearing & Speech 101 North Court Street (b) (6) Ripley, WV 25601 344-4400 ↓ ↓ ↓ ↓ ↓ ↓↓8/31/2017 N N Simmerman Hearing & Speech 3058 Mount Vernon Road Hurricane, WV 25526 344-4400 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/27/2017 N N Simmerman Hearing & Speech-- Simmerman, Gregory 344-4400 Audio Jan-18 12/31/18 1/3/17 12/5/16 6/28/17 6/28/17 "" " Steinhoff Consult Service--Steinhoff, William 2419.5 Jackson Ave Point Pleasant, WV 25550 740-656-4599 MA Feb-18 12/31/18 1/3/17 12/5/16 6/28/17 6/28/17 7/10/2017 N N Story Consulting Services Inc 306 Hospital Dr Ste 202D South Williamson, KY 41503 615-943-6379 ↓ ↓ ↓ ↓ ↓ ↓↓4/25/2017 N N VENDOR CREDENTIALING

Story Consulting Services Inc-- Karam, Anthony B ↑ DO Apr-19 2/28/18 12/5/16 12/5/16 6/28/17 6/28/17 "" "

Story Consulting Services Inc-- Waltrip, William ↑ MD Apr-19 6/30/18 12/5/16 12/5/16 6/7/17 6/28/17 "" " Synergy Psychological Services-- Reynolds, Mareda 511 Sixth Ave St Albans, WV 25177 727-1302 MA Jan-18 6/30/19 12/5/16 12/5/16 6/8/17 6/28/17 12/6/2016 N N Thakker, Ganpat 3100 MacCorkle Ave SE Ste 207 Charleston, WV 25304 (b) (6) MD Nov-18 6/30/19 12/5/16 12/5/16 6/16/17 6/28/17 12/29/2016 N N The Hearing Place (b) (6) 420 Greenway Ave South Charleston, WV 25309 766-6555 ↓ ↓ ↓ ↓ ↓ ↓↓12/7/2016 N N

The Hearing Place--Harris, Gary 766-6555 Audio July-19 12/31/18 12/5/16 12/5/16 6/28/17 6/28/17 "" "

The Hearing Place--Porter, Bethany 766-6555 Audio July-19 12/31/18 12/5/16 12/5/16 6/28/17 6/28/17 "" " Tri State Occupational Medicine 702 6th Ave (b) (6) Huntington, WV 25701 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓1/10/2017 Y N Tri State Occupational Medicine 1219 Virginia St East Suite 102 Charleston, WV 25301 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓8/17/2017 Y N Tri State Occupational Medicine 200 George St Suite 1 Beckley, WV 25801 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓1/12/2017 Y N Tri State Occupational Medicine 189 Pinnell St (b) (6) Ripley, WV 25271 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓11/28/2016 Y N Tri State Occupational Medicine 3696 Jefferson St N Lewisburg, WV 24901 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓7/13/2017 Y N Tri State Occupational Medicine 13 White St Logan, WV 25601 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓2/28/2017 Y N Tri State Occupational Medicine 508 New Hope Rd Suite 204 Princeton, WV 24740 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓5/18/2017 Y N Tri State Occ Med SLP Beckley 200 George St Ste 1 Beckley, WV 25801 800-929-8766 ↓ ↓ ↓ ↓ ↓ ↓↓7/21/2017 Y N

Tri State Occupational Medicine-- New To Panel New Added Adkins. Jimmy Ray ↑ PA-C July-19 3/31/19 Added 7/28/17 7/28/17 5/8/17 5/8/17 "" "

Tri State Occupational Medicine-- Beard, Kip ↑ MD Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 "" "

Tri State Occupational Medicine-- Namsupak, James ↑ MD Dec-18 6/30/19 12/12/16 12/12/16 6/16/17 6/28/17 "" " VENDOR CREDENTIALING

Tri State Occupational Medicine--Parsley, Deidre ↑ DO Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 "" " Tri State Occ Med SLP Beckley-- Riffe, Kara ↑ SLP Jan-19 12/31/18 1/9/17 1/9/17 6/28/17 6/28/17 "" " Stopped Tri State Occupational Medicine-- Stopped doing doing Sabio, Arturo ↑ MD Feb-18 6/30/17 12/6/16 12/6/16 exams 12/2016 exams n/a n/a Y Tug River Mount View Health Center 950 Mount View Rd Ste 500 (b) (6) Welch, WV 24801 436-4798 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 9/27/2017 N N Tug River Health Assoc Inc 5883 Black Diamond Hwy Gary, WV 24836 448-2101 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 6/29/2017 N N Tug River Health Assoc Inc-- New To Panel New Added Fain, Jennifer APRNAug 6/30/19 Added 7/28/17 7/28/17 7/28/17 6/28/17 " " " Tug River Health Assoc Inc-- New To Panel New Added Rash, Monique APRNAug 6/30/19 Added 7/28/17 7/28/17 7/28/17 6/28/17 " " " Vision Consultants--Beres, Michael Kruger Bldg 4th Floor Hospital Dr Logan, WV 25601 792-1480 MD-Opth Feb-18 6/30/18 12/6/16 12/6/16 6/28/17 6/28/17 4/27/2017 N N Welch Family Care 922 Virginia Ave (b) (6) Welch, WV 24801 436-8066 ↓ ↓ ↓ ↓ ↓ ↓ ↓ 4/13/2017 N N Welch Family Care-- Dumapit Jr, Ruperto D ↑ MD Apr-19 6/30/18 4/17/17 4/17/17 6/28/17 6/28/17 "" " Wiles, John F (b) (6) St Albans, WV 25177 (b) (6) OD Feb-18 6/30/18 12/6/16 12/6/16 7/13/17 6/28/17 12/7/2016 N N Zeigler, Cherie (b) (6) Huntington, WV 25701 (b) (6) MA Feb-18 6/30/19 12/6/16 12/6/16 6/8/17 6/28/17 6/5/2017 N N Clarksburg Vendor Credentialing: Audia, Joseph OD (b) (6) Salem, WV 26426 (b) (6) Optometrist Apr-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 Behavioral Health Assessments- Holly Coville MA- 4453 National Rd. Triadelphia WV 26059 304-909-0185 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 8/21/2017 Y N (b) (6) Cox, Kevin Elkins, WV 26241 (b) (6) Optha Feb-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N N Dr. Biundo - Bethany Honce, M.D. (b) (6) Morgantown, WV 26505 (b) (6) Internist Jun-18 6/30/2018 2/2/2017 2/2/17 11/7/2017 11/7/17 4/4/2017 Y Y (b) (6) Dunn, Paul A. (b) (6) Parkersburg, WV 26105 (b) (6) Psych Feb-18 12/31/17 2/2/17 2/2/17 11/7/17 11/07/17 1/3/2017 N N Eastern Psych SVC of WV- Jill Barnes Pyles

278 N High St. STE 1 Romney WV 26757 304-822-3429 Psych Feb-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/15/2017 N N VENDOR CREDENTIALING

Statement DDS License License OIG & License OIG & Onsite Key Removed Provider's of License PRO Vendor Phone # FEIN # Expiration Verification SAMS Verification SAMS Review Provider from DDS Comments Vendor Name & Specialty Agreement Number Initials ID # Date Date Check Date Check Date (Y/N) CE Panel Address Date Eastern Psych SVC of WV- Sheri Coleman (b) (6) (b) (6) 278 N High St. STE 1 Romney (b) (6) (b) (6) WV 26757 304-822-3429 Psych Feb-18 12/31/17 2/2/17 2/2/17 8/3/17 08/03/17 9/15/2017 N N Family and Marital Counseling Center- Robert J. Klein EDD 5 Brown Ave. Weston WV, 26452 304-269-3923 Psych Feb-18 3/31/19 2/2/17 2/2/17 8/3/17 08/03/17 2/13/2017 N N (b) (6) Frame, Ronald D. Parkersburg WV, 26101 (b) (6) Optometrist Oct-19 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 Fremouw Sigley Psych Assoc. Traci Berry Harris- 1224 B Pineview Dr. Morgantown WV, 26505 304-598-2300 Psych Mar-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/27/2017 N N Fremouw Sigley Psych Assoc. Edward Baker- 1224 B Pineview Dr. Morgantown WV, 26505 304-598-2300 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 9/27/2017 N N Greenbrier Audiology--Stout, Laura 7 11th St. Elkins, WV 26241 304-630-6002 Audiology May-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 8/3/2017 N N (b) (6) Joseph, Sharon J PHD Elkins, WV 26241 (b) (6) Psych May-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 7/7/2017 N N Mangold, Terry S. OD (b) (6) Keyser WV 26726 (b) (6) Optometrist Sep-19 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 7/20/2017 N N Mansuetto Psychological Services, PLLC- Aileen Mansuetto, MA 141 Key Ave. Wheeling, WV 26003 304-243-5600 2/2/17 08/03/17 (b) (6) Psych Mar-18 6/30/18 2/2/17 8/3/17 1/18/2017 N Y Marshall, Katherine M.S. C/O work force wv 200 8th street Marlinton wv 24954 304-660-7656 Psych May-19 3/31/19 12/2/16 12/2/16 6/27/17 6/27/17 4/24/2017 N N Monongahela Valley Assoc. Health-Seeta R. Vangala- 1322 Locust Ave. Fairmont, (b) (6) WV 26554 304-367-8719 Pediatric Mar-18 6/30/2019 2/2/17 2/2/17 8/3/17 8/3/2017 7/20/2017 N N Monongahela Valley Assoc. Health- Smitha Pati- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2019 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N N Monongahela Valley Assoc. Health- Himanshu Paliwal- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2019 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N N Monongahela Valley Assoc. Health- Ryan Hall- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Internist Mar-18 6/30/2018 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N N Monongahela Valley Assoc. Health- Sarah Hall- 1322 Locust Ave. Fairmont, WV 26554 304-367-8719 Pediatric Mar-18 6/30/2018 2/2/17 2/2/17 8/3/2017 8/3/2017 7/20/2017 N N Morgan Psych Services- Morgan Morgan- 102 E Main St. #1 Buckhannon, WV 26201 304-472-7778 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/13/2017 Y N Morgantown Eye Assoc. -Erica Mancini- 3000 Hampton Center STE A Morgantown WV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N N Morgantown Eye Assoc.- Dona Wratchford- 3000 Hampton Center STE A Morgantown WV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N N Morgantown Eye Assoc. Thomas Stout- 3000 Hampton Center STE A Morgantown WV 26505 304-598-2020 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 2/22/2017 N N Mountain View Ear Nose & Throat- Peter Johnson- 112 Medical Circle Winchester, VA 22601 540-542-1995 ENT Apr-18 7/31/18 2/2/17 2/2/17 8/3/17 08/03/17 NN VENDOR CREDENTIALING

431 S Raleigh St. Martinsburg WV 25401 304-263-9095 Psych Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 9/11/2017 Y Psychological Consulting- Michael McDaniel MA 431 S Raleigh St. Martinsburg WV 25401 304-263-9095 Psych Mar-18 3/31/18 2/2/17 2/2/17 8/3/17 08/03/17 9/11/2017 Y (b) (6) Robinson, Jennifer Fairmont WV, 26555 (b) (6) Psych Mar-18 9/30/18 2/2/17 2/2/17 8/3/17 08/03/17 3/10/2017 N N (b) (6) Schmitt, Thomas J. MD New Martinsville, WV 26155 (b) (6) Internist Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 5/30/2017 N N

Joseph E. Schreiber, DO (b) (6) , Weirton WV 26062 (b) (6) 2/2/17 08/03/17 (b) (6) Internist Mar-18 6/30/19 2/2/17 8/3/17 7/11/2017 N 7/18/2017 (b) (6) Selario, James A. Clarksburg WV 26301 (b) (6) Optometrist Mar-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 Sella, Gabriel E. MD 92 N 4th St. Suite 12 Martins Ferry, OH 43935 (b) (6) Family Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 12/8/2016 N Sethi, Sushil M. MD MPH FCCP-Fairmont 1228 Country Club Rd Suite 14 419-756-4010 2/2/17 11/07/17 (b) (6) Fairmont, WV 26554 Family Feb-18 6/30/19 2/2/17 11/7/17 Y Sethi, Sushil M. MD MPH FCCP-Marietta 1300 Pike St - Beverly Medical Center (b) (6) Marietta, OH 45750 419-756-4010 Family Feb-18 6/30/19 2/2/17 2/2/17 11/7/17 11/07/17 3/28/2017 Y 3/28/2017 Spaulding Psych Services- Cynthia Spaulding- 216 W North St. Harrisville WV, 26362 304-643-5399 Psych Feb-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 7/25/2017 N Spaulding Psych Services- Amy Guthrie MA- 1809 Dupont Rd STE 3 Parkersburg, WV 26101 304-861-5184 Psych Feb-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 7/25/2017 N Tebay Psychological Services- Brenda Tebay- 1303 Grand central Ave. Vienna WV 26105 304-482-2917 Psych Feb-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 8/18/2017 N Therapy Source, Inc.-Tracy N. Bartlett- 5215 Militia Hill Rd. Plymouth Meeting (b) (6) PA 19462 484-342-2000 Speech Apr-19 5/31/2019 4/5/2017 4/5/17 8/3/2017 8/3/2017 N Trainor, Gregory E. MA & Assoc.- 155 Armstrong St. Keyser WV 26726 304-788-1138 Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 9/8/2017 Y N Trainor, Gregory E.--Tracy Cosner- Shepard- 155 Armstrong St. Keyser, WV 26726 304-788-1138 Psych Mar-18 3/31/19 2/2/17 2/2/17 8/3/17 08/03/17 9/8/2017 Y N Tri State Occupational Medicine 1400 Johnson Ave Blake Center Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Bridgeport, WV 26330 800-929-8766 VENDOR CREDENTIALING

Statement DDS License License OIG & License OIG & Onsite Key Removed Provider's of License PRO Vendor Phone # FEIN # Expiration Verification SAMS Verification SAMS Review Provider from DDS Comments Vendor Name & Specialty Agreement Number Initials ID # Date Date Check Date Check Date (Y/N) CE Panel Address Date Tri State Occupational Medicine (b) (6) (b) (6) Randolph Center-Harrison Ave (b) (6) Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Elkins, WV 26241 800-929-8766 3/17/17 y Tri State Occupational Medicine 617 River St Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Gassaway, WV 26624 800-929-8766 3/15/17 Y Tri State Occupational Medicine 196 Riverview Dr. Sutton, Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg (b) (6) WV 26601 800-929-8766 Tri State Occupational Medicine 103 South Tennesse Ave Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Martinsburg, WV 25401 800-929-8766 8/24/17 Tri State Occupational Medicine Rt 50 E - In Sun Diagnostics Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Romney, WV 26757 800-929-8766 8/22/17 y Tri State Occupational Medicine 706 Division St Credentialing For Physicians Found With Charleston Credentialing onsite visit by Clarksburg Parkersburg, WV 26101 800-929-8766 2/8/17 YN Victory Services--Jill Hornish MA 411 Main St. Rt 74 Pennsboro (b) (6) WV 26415 304-483-6245 Psych Mar-18 3/31/18 2/2/17 2/2/17 8/3/17 08/03/17 5/23/17 N N Virginia Center For Neuroscience--Seth Tuwiner MD, 19450 Deerfield Ave. STE 703-858-5454 2/2/17 08/03/17 (b) (6) 175 Leesburg VA 20176 Neurology Mar-18 1/31/18 2/2/17 8/3/17 N N Vision Care Assoc. Inc.--Scott Lauer 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 Vision Care Assoc. Inc.--C. Robert Welshans- 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 Vision Care Assoc. Inc.--Jerry Lantz 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 N Vision Care Assoc., Inc.--Deanna Jackson- 2014 Dudley Ave. Parkersburg WV 26101 304-422-1841 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 N Vision Care Assoc. Inc.--Vicki Lauer 2014 Dudley Ave. Parkersburg WV 26101 304-422-184 Optometrist Jul-18 6/30/18 2/2/17 2/2/17 8/3/17 08/03/17 N Wheeling Hospital Speech--Morgan DeGarmo, 1021 MT Dschantal Rd. #2 Wheeling, WV 26003 304-243-3770 Speech Mar-18 12/31/18 2/21/17 2/21/17 8/3/17 8/3/2017 11/18/16 N Wheeling Hospital Speech--Amy Toth Beaver, 1021 MT Dechantal Rd. #2 (b) (6) Wheeling WV, 26003 304-243-3770 Speech Mar-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 11/8/16 N (b) (6) Wilkins, Krista Clarksburg WV, 26301 (b) (6) Speech Mar-18 12/31/18 2/2/17 2/2/17 8/3/17 08/03/17 n Wilkinson, Amos W. 1160 Johnson Ave. STE 103 Bridgeport, WV 26330 (b) (6) Optha Apr-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 (b) (6) Yost, T. M. EDD Fairmont WV, 26554 (b) (6) Psych Mar-18 9/30/19 2/2/17 2/2/17 8/3/17 08/03/17 5/26/17 Y Zyznewsky, Wladimir MD--Valley Professional Center STE 301 2115 Chapline St, Wheeling WV 26003 (b) (6) Neurology Mar-18 6/30/19 2/2/17 2/2/17 8/3/17 08/03/17 WV FY 2017

MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials CHARLESTON CHARLESTON CHARLESTON Summersville Reg. Hospital/Summersville, WV 10/5/2016 Boone Memorial Hosp/Madison, WV 10/6/2016 Pleasant Valley Hosp./Pt. Pleasant, WV 10/11/2016 Southern Highlands Hosp/Princeton, WV 10/13/2016 Community Care of WV/Clay, WV 10/26/2016 Monroe Health/Peterstown, WV 11/1/2016 (b) (6) Seneca Health Services/Maxwellton, WV 11/3/2016 Southern Highlands Hosp/Welch, WV 11/9/2016 Summers Co. ARH/Hinton, WV 11/15/2016 Webster Co. Mem. Hosp/Webster Springs, WV 11/16/2016 St. Mary's Family Medicine/Milton, WV 11/22/2016 Muscari Family Medicine/Pineville, WV 11/29/2016 Alderson Family Medicine/Alderson, WV 12/1/2016 Tug Valley ARH/ S. Williamson, KY 1/9/2017 Thomas Memorial Hosp/Charleston, WV 1/13/2017 Erma Byrd Clinical Center/Huntington, WV 1/17/2017 Tug River Health/Gary, WV 1/19/2017 Big Otter Clinic/ Ivydale, WV 1/24/2017 Clay County Health Dept/Clay, WV 1/24/2017 Prestera Center / Wayne, WV 1/30/2017 Valley Health/ Wayne, WV 1/30/2017 New Hope Family Practice/Princeton, WV 2/1/2017 Williamson Memorial Hosp/ Willaimson, WV 2/3/2017 Logan Regional Hosp. Logan, WV 2/7/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Greenbrier Valley Hosp. Roncerverte, WV 2/8/2017 Mercer Health Center, Bluefield, WV 2/14/2017 Rainelle Medical Ctr, Rainelle, WV 2/15/2017 Jarrell Family Medicine, Ceredo, WV 2/16/2017 Roane General Hosp., Spencer, WV 2/17/2017 Bluestone Health Center, Princeton, WV 2/21/2017 Camden Family Health Craigsville, WV (b) (6) 2/22/2017 Three Rivers Family Pract., Kermit, WV 2/23/2017 Madison Medical, Madison, WV 3/1/2017 Camden Family Health Cowen, WV 3/2/2017 Monroe Health/Union, WV 3/7/2017 Seneca Health Services/Summersville, WV 3/9/2017 Hinton Health Right/Hinton, WV 3/15/2017 Greenbrier Clinic/White Sulphur Springs, WV 3/16/2017 Gilbert Health/Gilbert, WV 3/23/2017 Mercer Co. Health Dept, Bluefield, WV 3/28/2017 Tug River Health/Gary, WV 3/30/2017 Welch Family Care, Welch, WV 4/13/2017 Clay County Health Dept/Clay, WV 4/17/2017 Nicholas County Health Dept/Summersville, WV 5/1/2017 Mingo County Health Dept/Pt. Pleasant, WV 5/23/2017 ARH Tug Valley Medical Assoc., Gary, WV 6/9/2017 Mercer County Health Dept, Bluefield, WV 6/13/2017 Cabell Huntington Family Med.Ctr, Kenova, WV 6/30/2017 Summit Orthopedics, S. Charleston, WV 7/12/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Moses Family Medicine, Huntington, WV 7/18/2017 Boone Memorial Hosp/Madison, WV 8/6/2017 Raleigh General Hospital/Beckley, WV 8/24/2017 Cabell Huntington Hospital, Huntington, WV 7/31/2017 Prestera Center / Wayne, WV 8/22/2017 Pikeville Medical Center, Pikeville, Ky 8/25/2017 King's Daughters Hospital, Ashland, Ky 8/30/2017 (b) (6) Rainelle Med. Ctr., Rainelle, WV 9/6/2017 Summersville Reg. Hospital/summersville, WV 9/6/2017 Raleigh County Health Dept. Beckley, WV 9/7/2017 Prestera Center / Winfield, WV 9/8/2017 Pleasant Valley Internist, Pt. Pleasant, WV 9/13/2017 Little Beaver Family Clinic, Beaver, WV 9/14/2017 Mercer Co. Health Dept, Bluefield, WV 9/15/2017 Prestera Huntington, WV 9/15/2017 Boone County Health Dept, Madison, WV 8/29/2017 Greenbrier Valley Hosp. Roncerverte, WV 9/19/2017 Eden Family Practice, Kermit, WV 9/19/2017 Ohio Valley Physician, Gallipolis, OH 9/20/2017 Summersville Family Med. Summersville, WV 9/21/2017 Dr. Santamaria, Logan, WV 9/26/2017 Gilbert Health , Gilbert, WV 9/27/2017 CLARKSBURG CLARKSBURG CLARKSBURG WVU (Ruby) Morgantown, WV 12/29/2016 Mon Gen. Hosp. Morgantown, WV 10/3/2016 (b) (6) MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Love Mem. Clinic Moorefield, WV 12/7/2016 St. Joseph's Hospital, Buckhanon, WV 12/29/2016 Broaddus Hosp., Phillippi 12/29/2016 Berkeley Med. Ctr, Martinsburg, WV 11/30/2016 Shenandoah Med. Serv. Martinsburg, WV 11/30/2016 Davis Med. Ctr, Elkins, WV 11/3/2016 Potomic Valley Hosp., Keyser, WV 10/14/2016 (b) (6) Myers Clinic, Phillippi 12/29/2016 Hampshire Mem. Hosp, Romney, WV 11/23/2016 War Mem Hosp, Berkley Springs, WV 12/6/2016 Preston Mem. Hosp, Kingwood, WV 12/13/2016 Ohio Valley Med. Ctr., Wheeling, WV 10/6/2016 Change Inc., Weirton, WV 10/22/2016 Trinity Health System, Steubenville, Oh 12/8/2016 Reynolds Mem. Hosp, Glen Dale, WV 12/10/2016 Weirton Med. Ctr, Weirton, WV 12/21/2016 Pocahontas Mem. Hosp., Buckeye, WV 10/27/2016 Pendleton Comm. Care, Franklin, WV 12/12/2016 Grant Mem. Hosp. Petersburg, WV 11/2/2016 WVU Ruby, Morgantown, WV 1/11/2017 Myers Clinic & AB Hospital , Phillipi, WV 2/21/2017 Grant Mem. Hosp., Petersburg, WV 2/28/2017 Pendleton Community Care, Franklin, WV 3/22/2017 St. Josephs Hospital, Buckhannon, WV 2/1/2017 Davis Med. Ctr., Elkins, WV 2/3/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Potomic Valley Hosp, Keyser, WV 1/30/2017 Jefferson Med. Ctr., Ranson, WV 1/19/2017 War Memorial Hosp., Berkeley Springs 3/16/2017 Preston Mem. Hosp., Kingwood, WV 2/13/2017 Grafton City Hosp., Grafton, WV 3/4/2017 Shenandoah Mem., Martinsburg, WV 1/21/2017 East Ohio Reg. Hosp., Martins Ferry, Ohio (b) (6) 1/5/2017 Wheeling Hosp., Wheeling, WV 2/6/2017 Stonewall Jackson Mem. Hosp., Weston, WV 1/15/2017 Change, Inc., Weirton, WV 1/19/2017 Wood Health Clinic, Moundsville, WV 2/16/2017 BCH Fox Run Hospital, St. Clairsville, Ohio 1/28/2017 Minnie Hamilton Health Ctr., Grantsville, WV 2/4/2017 Coplin Med. Ctr, Elizabeth, WV 2/8/2017 Wheeling Health Right, Wheeling, WV 2/12/2017 Wetzel Co. Hosp., New Martinsville, WV 2/2/2017 Family Medical Care, Weirton, WV 2/18/2017 Camden Clark Medical Ctr, Parkersburg, WV 3/1/2017 Ohio Valley Med. Ctr., Wheeling, WV 3/1/2017 Wirt Co. Health Services, Elizabeth, WV 3/8/2017 Weirton Med. Ctr., Weirton, WV 2/17/2017 Stonewall Jackson Mem. Hosp., Weston, WV 3/10/2017 River Valley Health, Ravenswood, WV 3/22/2017 John Manchin Sr. Health Care Ctr, Fairmont, WV 3/29/2017 Sistersville Gen. Hosp, Sistersville, WV 3/6/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Healthways, Weirton, WV 3/8/2017 PARS Neurosurgical Assoc., Parkersburg, WV 2/22/2017 Tri County Health, French Creek, WV 1/4/2017 Webster Co. Mem. Hosp/Webster Springs, WV 1/19/2017 Garrett Mem. Hosp., Oakland, MD 2/16/2017 WVU Ruby, Morgantown, WV 4/4/2017 Camden on Gauley, Camden on Gauley, WV (b) (6) 4/12/2017 Grant Mem. Hosp, Petersburg, WV 5/1/2017 Pocahontas Co. Health Marlinton, WV 4/25/2017 War Memorial Hosp., Berkeley Springs 5/26/2017 Davis Med Ctr, Elkins, WV 5/16/2017 Potomic Valley Hosp, Keyser, WV 4/28/2017 Jefferson Med. Ctr, Ranson, WV 5/22/2017 Monongalia Gen. Hosp, Morgantown, WV 5/1/2017 Preston Co. Health , Kingwood, WV 4/26/2017 Berkeley Med. Ctr. Martinsburg, WV 4/14/2017 Shenandoah Mem., Martinsburg, WV 4/14/2017 Cardinal Ped's Morgantown, WV 5/1/2017 Weirton Med. Ctr., Weirton, WV 6/7/2017 Fairmont Reg. Med. Ctr. Fairmont, WV 4/13/2017 Manchin Clinic South, Fairmont, WV 4/18/2017 Wood Health Clinic, Moundsville, WV 4/20/2017 Sistersville Gen. Hosp, Sistersville, WV 4/25/2017 East Liverpool City Hosp, East Liverpool, Oh 5/2/2017 Brown Family Practice, Wheeling, WV 6/16/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Healthways, Weirton, WV 5/16/2017 Robert Sams, MD (Worthington CTR) Parkersbur 5/11/2017 Reynolds Mem. Hosp, Glen Dale, WV 4/17/2017 Ohio Valley Med. Ctr., Wheeling, WV 5/25/2017 Wheeling Hosp., Wheeling, WV 6/1/2017 Fairmont Reg. Med. Ctr, Fairmont, WV 6/8/2017 Wheeling Health Right, Wheeling, WV (b) (6) 6/17/2017 Braxton Mem. Hosp., Gassaway, WV 6/5/2017 Stonewall Jackson Mem. Hosp., Weston, WV 6/9/2017 East Ohio Reg. Hosp, Martins Ferry, Ohio 6/12/2017 Coplin Med. Ctr, Elizabeth, WV 6/14/2017 Minnie Hamilton Health Ctr., Grantsville, WV 6/21/2017 PARS Neurosurgical Assoc., Parkersburg, WV 6/26/2017 United Hosp. Ctr. Bridgeport, WV 6/22/2017 Ritchie Co. Primary Care Assoc, Harrisville, WV 4/26/2017 Grant Co. Health Dept Petersburg, WV 5/10/2017 Tri County Health, French Creek, WV 5/18/2017 Morgan Co. Health, Berkeley Springs, WV 5/26/2017 Webster Co. Mem. Hosp/Webster Springs, WV 5/30/2017 Pocahontas Mem. Hosp Buckeye, WV 6/9/2017 Pendelton Community Care Franklin, WV 6/13/2017 Myers Clinic & Broaddus Hospital , Phillipi, WV 6/15/2017 Preston Mem. Hosp., Kingwood, WV 6/19/2017 Petersburg Med. Group, Petersburg, WV 6/19/2017 WVU Ruby, Morgantown, WV 7/24/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Hedgesville, Health Care Hedgesville, WV 8/21/2017 Grant Mem. Hosp. Petersburg, WV 7/28/2017 Pendeleton Com. Care. Franklin, WV 8/15/2017 War Memorial Hosp., Berkeley Springs 8/11/2017 Davis Med. Ctr., Elkins, WV 8/3/2017 Potomic Valley Hosp, Keyser, WV 7/20/2017 Grant Co. Health Dept Petersburg, WV (b) (6) 8/18/2017 Pocahontas Mem. Hosp Buckeye, WV 7/18/2017 Preston Mem. Hosp., Kingwood, WV 7/25/2017 Berkeley Med. Ctr. Martinsburg, WV 7/10/2017 Monongalia Gen. Hosp, Morgantown, WV 8/17/2017 Camden Clark Medical Ctr, Parkersburg, WV 7/14/2017 Weirton Med. Ctr, Weirton, WV 7/26/2017 Minnie Hamilton Health Care Ctr. Grantsville, WV 7/26/2017 Ohio Valley Med. Ctr. Wheeling, WV 7/17/2017 Braxton Mem. Hosp., Gassaway, WV 8/25/2017 Mid-Ohio Valley Med. Group Parkersburg, WV 8/29/2017 Trinity Health System, Steubenville, Ohio 7/21/2017 John Manchin Sr. Health Care Ctr, Fairmont, WV 9/16/2017 Wheeling Hosp., Wheeling, WV 8/1/2017 Stephen Alatis, DO Weirton, WV 9/6/2017 BCH Fox Run Hospital, St. Clairsville, Ohio 9/19/2017 Wood Health Care Clinic, Moundsville, WV 9/21/2017 Fairmont Reg. Med. Ctr., Fairmont, WV 9/1/2017 PARS Neurosurgical Assoc., Parkersburg, WV 8/23/2017 MER Visits PRO Vendor Name & Address Onsite Visit Date Comments initials Change, Inc., Weirton, WV 8/25/2017 Coplin Med. Ctr, Elizabeth, WV 8/30/2017 Stonewall Jackson Mem. Hosp., Weston, WV 7/13/2017 Sistersville Gen. Hosp, Sistersville, WV 7/19/2017 Northwood Health System, Wheeling, WV 7/28/2017 Preston Co. Health , Kingwood, WV 8/29/2017 Randolph Co. Health Dept., Elkins, WV 9/6/2017 (b) (6) Shenandoah Valley Med. Sys, Martinsburg, WV 9/11/2017 Petersburg Med. Group, Petersburg, WV 9/14/2017 Garrett Mem. Hosp., Oakland, MD 9/25/2017 Mountaintop Health Ctr. , Thomas, WV 9/29/2017 Wyoming FY 2017

License Disciplinary Last review date by Date of last oversite Expired Date SAM Check Psychologist Number Action DDS visit Company Name Robert Bayuk Ed.D (b) (6) 6/30/2018 none 9/15/2017 No Exclusion none to date self Timothy Blaney Ph.D 6/30/2018 none 9/15/2017 No Exclusion 2/26/2015 Summit Psychological Services Michael Enright Ph.D 6/30/2018 none 9/15/2017 No Exclusion 6/4/2015 self Mark Gibson Ph.D 6/30/2018 none 9/15/2017 No Exclusion 9/15/2015 Southwest Counseling Services Theo Riley Ph.D 6/30/2018 none 9/15/2017 No Exclusion 10/9/2016 self Richard Norton Ph.D 6/30/2018 none 9/15/2017 No Exclusion 9/20/2015 self Mary Jo Jeffres Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/15/2014 self James Wyssmann Ph.D 6/30/2018 none 9/15/2017 No Exclusion 4/6/2016 self Eric Silk Ph.D 6/30/2018 none 9/15/2017 No Exclusion 10/9/2016 self 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Pamela Fuller Ph.D Frontier Psychological Associates 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Cora Klotzbach Ph.D Frontier Psychological Assocaites 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Denise Debarre Ph.D Frontier Psychological Assocaities 6/30/2018 none 9/15/2017 No Exclusion 8/5/2015 Julie Jett Ph.D Frontier Psychological Assocaities 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Melissa Jenkins Ph.D Park Ridge Behavioral health care Kenneth Bell Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Park Ridge Behavioral Health Mark Watt Ph.D 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Snowy Range Consulting Steven Newman Ph.D 6/30/2018 none 9/15/2017 No Exclusion 4/11/2017 self Grant Fleming Ph.D 6/30/2018 none 9/15/2017 No Exclusion 2/3/2017 Fleming Associates 6/30/2018 none 9/15/2017 No Exclusion 8/8/2016 Charles Powell Ph.D Park Ridge Behavioral Healthcare 6/30/2018 none 9/15/2017 No Exclusion 6/11/2015 Cheryl Wise Ph.D Fremont Counseling Center(Lander) Brent Andersen Ph.D 6/30/2018 none 9/15/2017 No Exclusion 6/3/2015 own (Rock Springs)

12/19/2017 none 9/15/2017 No Exclusion none to date own (Scottsbluff) keeps working Matthew Hutt Ph.D with temporary license in wyoming. 6/30/2018 none 9/15/2017 No Exclusion none to date Wayne Reynolds Ph.D Cloud Peak Counseling (Worland) Mark Holland Ph.D 6/30/2018 none 9/15/2017 No exclusion 1/1/2016 Park Ridge Behavioral health Amanda Turlington Ph.D 6/30/2018 none 9/15/2017 No exclusion 10/3/2016 Minda Spa/ Own Lynn Heeren Ph.D 6/30/2018 none 9/15/2017 No exclusion none to date Own Now on own under 6/30/2018 none 9/15/2017 No Exclusion none to date Barbara St. Clair Ph.D Meadowlark(Gillette) Carol Pastore-Watkins Ph.D 6/30/2018 none 9/15/2017 No Exclusion none to date own practice

License Disciplinary Date of last oversite Expired Date Review Date DDS SAM Check Psychiatrist: Number Action visit Company Name Frank Wheeler MD (not using) (b) (6) 6/30/2017 none 9/30/2016 No Exclusion 8/20/2013 Lander Valley Physicains

License Disciplinary Date of last oversite Expired Date Review Date DDS SAM Check Consultants Number Action visit Company Name Grant Fleming Ph.D (b) (6) 6/30/2018 none 9/15/2017 No Exclusion see above Fleming Associates Steven Newman Ph.D 6/30/2018 none 9/15/2017 No Exclusion see above self Grey Rich Ph.D 6/30/2018 none 9/15/2017 No Exclusion consultant only self Sheri Fluellen Ph.D 6/30/2018 none 9/15/2017 No Exclusion consultant only Mind Spa

License Disciplinary Date of last oversite Expired Date Review Date DDS SAM Check Not using for ces/ consulting Number Action visit Company Name Nohl Sandall Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion unknown self Dean Schroeder Ed.D (retired) did (b) (6) 6/30/2017 none 9/30/2016 No Exclusion unknown ce/consult. self Scott Wylie Ph.D (not using) did ces/ 6/30/2017 Yes-see File 9/30/2016 No Exclusion unknown consult. Medical Psychology Associates 6/30/2013 none 9/30/2016 No Exclusion unknown Stuart Krause Ph.D (not using) Frontier Psychological Associates 6/3/2001 none 9/30/2016 No Exclusion unknown Anton Ornette Tolman Ph.D (retired) Frontier Psychological Assocaites Left Wellness Centers 7/11/13, in 6/30/2017 none 9/30/2016 No Exclusion unknown Susan Fisher-Johnston Ph.D (not using) CO 6/30/2014 none 9/30/2016 No Exclusion 8/15/2012 Angela Ehrlick Ph.D (no longer using) Rocky Mountain Behavioral Health Jamie Brass Ph.D (not using) 7/26/2013 none 9/30/2016 No Exclusion 8/22/2012 Left southwest co 9/1/12, in UT was under Fremont Counseling/ on 6/30/2017 none 9/30/2016 No Exclusion 8/21/2012 Marc McLaughlin Ph.D (not using) own 6/30/2017 none 9/30/2016 No Exclusion none Laura McKee Ph.D (withdrew as ce pro.) 6/30/2017 none 9/30/2016 No Exclusion unknown Christine Winter Ph.D(moved out of state) self 6/30/2017 none 9/30/2016 No Exclusion 5/2/2014 Geoffrey Sherman Ph.D (too busy) Abintra Psychological Associates 6/20/2016 none 9/30/2016 No Exclusion 2/27/2015 Brook England Ph.D (did not work out) self Jerry Post Ph.D (not using) did ces/ 6/30/2017 none 9/30/2016 No Exclusion none to date consult. was a partner with Wylie Dina Tassione Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion none to date Tassione Psychological Services Alison Ohashi Ph.D did ces/ consult. 6/30/2017 none 9/30/2016 No Exclusion 5/26/2015 self Gerald Manwill Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion none to date self Joshua Popkin Ph.D (not using) 6/30/2017 none 9/30/2016 No Exclusion 2/1/2016 Own Margaret Hocheiser Ph.d did not want to 6/30/2017 none 9/30/2016 No Exclusion none do ces Own Wendy Gersing Ph.d did not want to do 6/30/2017 none 9/30/2016 No Exclusion none ces (b) (6) Comfort Care Nicolas Prat Ph.D 6/30/2017 none 9/30/2016 No Exclusion 6/17/2013 self License Disciplinary Last review Date of last Company Expired Date Provider Number Action date by DDS SAM check oversite visit Name

Physician (Using) North Big Horn (b) (6) 6/30/2018 none Richard Jay MD 9/15/2017 No Exclusion 10/9/2016 Hospital Cheyenne Jonathon 6/30/2018 none Family Medina MD 9/15/2017 No Exclusion 4/16/2017 Medicine

Terry R 6/30/2018 none Donaldson Donaldson MD 9/15/2017 No Exclusion 6/3/2015 Medical Clinic Cedar Hills Michael Jording 6/30/2018 none Family Clinic MD 9/15/2017 No Exclusion none (Newcastle) Lucase Wang 6/30/2018 none MD 9/15/2017 No Exclusion 7/14/2017 self Ann MacGuire 6/30/2018 none MD 9/15/2017 No Exclusion 8/13/2013 Self Ralph Heckard 6/30/2018 none MD 9/15/2017 No Exclusion 1/10/2017 self

Kirtikumar 6/30/2018 none Gillette Internal Patel MD 9/15/2017 No Exclusion 9/17/2015 Medicine Evanston Internal 6/30/2018 none Thomas Simon medical MD 9/15/2017 No Exclusion 8/5/2015 Association Occuapational Scott Johnston (b) (6) 6/30/2018 none Med Of NE WY MD 9/15/2017 No Exclusion 4/7/2016 (Gillette) Michele Michele 6/30/2018 none Bennett PC Bennett MD 9/15/2017 No Exclusion 4/6/2016 (Sheridan) Peter Crane 6/30/2018 none MD 9/15/2017 No Exclusion none self Howard Willis 6/30/2018 none DO 9/15/2017 No Exclusion 12/22/2017 Cedars Health Lander Valley 6/30/2018 none Gwen Libby MD 9/15/2017 No Exclusion 9/15/2016 Clinic Wilson 6/30/2018 none Bernales MD 9/15/2017 No Exclusion none Cedars Health Elizabeth Hills 6/30/2018 none DO 9/15/2017 No Exclusion none Cedars Health Timothy Maly 6/30/2018 (b) (6) MD 9/15/2017 No Exclusion 6/15/2017 Cedars Health

Physician License Disciplinary Date of last Company Expired Date Assistances Number Action Review Date SAM check oversite visit Name Evanston Bailey Snyder (b) (6) 12/31/2017 none Internal PA-C 9/15/2017 No Exclusion 8/5/2015 Medicine Kenneth Sickel 12/31/2017 (b) (6) PA-C 9/15/2017 No Exclusion none Cedars

Nurse License Disciplinary Date of last Company Expired Date Practitioner Number Action Review Date SAM check oversite visit Name Diane Wrenn (b) (6) 12/31/2018 none NP 9/15/2017 No exclusion 12/22/2016 Cedars Health Rhonda (b) (6) 12/31/2018 none McLaughlin NP 9/15/2017 No exclusion 12/22/2016 Cedars Health

License Disciplinary Date of last Company Expired Date Consultants Number Action Review Date SAM check oversite visit Name Robert Kanard MD (b) (6) 6/30/2018 none (Consultant) 9/15/2017 No Exclusion # Consultant Michael Herber MD 6/30/2018 none (Consultant) 9/15/2017 No Exclusion # Consultant Darryl Bindschadler 6/30/2018 none MD (Consultant) 9/15/2017 No Exclusion # Consultant Rodney Anderson MD 6/30/2017 none (Consultant) not using 9/15/2017 No Exclusion # Consultant Harmon H Davis 6/30/2018 none (Consultant) 9/15/2017 No Exclusion # Consultant Thomas Toft MD 6/30/2018 none (Consultant) not using 9/15/2017 No Exclusion # Consultant

Philp Sharp MD 6/30/2018 none (Consultant) 9/15/2017 No Exclusion # Consultant Gene Halpren (b) (6) 6/30/2018 none (Consultant) 9/15/2017 No Exclusion # Consultant

License Disciplinary Physicians/PA/ Expired Date Date of last Company Number Action NP (Not using) Review Date SAM check oversite visit Name William Williams MD Sheridan (b) (6) 6/30/2015 none (no longer Internal using) 10/1/2016 No Exclusion 8/15/2012 Medicine Adolfo G Bagnarello MD 6/30/2015 none (no longer using) 10/1/2016 No Exclusion none self

Edward Wilson Coffeen clinic/ 6/30/2015 (b) (6) DO (no longer Wilson Family using) 10/1/2016 No Exclusion 8/14/2012 Practice

Nicole Caldwell 6/30/2017 none MD (no longer Disability Docs using) 10/1/2016 No Exclusion none Inc David Cesko MD (no longer 6/30/2017 (b) (6) Cesko Family using) 10/1/2016 No Exclusion none Medicine Richard Sorenson MD 6/30/2017 none (no longer Work Wise using) 10/1/2016 No Exclusion 8/21/2012 (Riverton) Karel D Capek MD (no longer (b) (6) 6/30/2017 none Midtown using) 10/1/2016 No Exclusion none Medical Group Joel Pull MD Greybull Family (No longer 6/30/2017 10/1/2016 No Exclusion none Clinic using) (b) (6) Marvin W Couch II MD 6/30/2017 (no longer Rawlins Family using) 10/1/2016 No Exclusion none Medical Michael Swenson MD 6/30/2017 Lander Medical (not using) 10/1/2016 No Exclusion none Clinic

Carlton Huitt 6/30/2014 none MD (not using) 10/1/2016 No Exclusion none self

Louis Roussalis 6/30/2017 none MD (no longer using) 10/1/2016 No Exclusion none self Kaci Gallo MD Lander Medical 6/30/2017 none (busy) 10/1/2016 No Exclusion 9/16/2014 Clinic

Amy Kenworthy 6/30/2017 none MD (lost office location) 10/1/2016 No Exclusion 8/20/2012 self Evanston Ardella Internal 6/30/2017 none Kemmler MD medical (retired) 10/1/2016 No Exclusion 8/22/2012 Association Tracy Potter (AKA Jackson) (b) (6) 12/31/2016 none Rock Springs PA-C 10/1/2016 No Exclusion 8/23/2012 Family Practice

*stop using due # # to customer service # # # # Trisha DeClue Lander Medical 12/31/2016 none FNP 10/1/2016 No Exclusion 8/20/2012 Clinic Shirley Schatza Lander Medical 12/31/2016 none NP 10/1/2016 No Exclusion 8/20/2012 Clinic

Melinda Poyer 6/30/2017 none Rock Springs MD 10/1/2016 No Exclusion 8/23/2012 Family Practice

*stop using due # # to customer service # # # # Midway Clinic 6/30/2016 none Demar Hill MD 10/1/2016 No Exclusion none (Basin) Grasslands Kristina 6/30/2016 none Medicine Behringer MD 10/1/2016 No Exclusion none (Cheyenne) WY Neurological 6/30/2017 none David Wheeler Associates MD 10/1/2016 No Exclusion none (Casper)

Family Medical 6/30/2017 none Mark Schueler Center Of MD 10/1/2016 No Exclusion 8/14/2012 Johnson Co David Pinedale Clinic/ 6/30/2017 none Kappenman (b) (6) Sublette Co MD 10/1/2016 No Exclusion none Rural Health

Kent M 6/30/2017 (b) (6) Laramie Kleppinger MD 10/1/2016 No Exclusion none Pediatrics Cathy Wilson NP (left cedars 12/31/2016 none health) 10/1/2016 No Exclusion 4/6/2016 Cedars Health 12/31/2016 (b) (6) Teresa Cady NP 10/1/2016 No exclusion none Cedars health

Red Desert 12/31/2018 none InstaCare (Rock Lori Turner NP 10/1/2016 No exclusion none Springs)

Plattle Valley 12/31/2018 none Jennifer Oiler Medical Center NP 10/1/2016 No exclusion none (Saratoga) Mary Freund North Big Horn 12/31/2016 none NP 10/1/2016 No exclusion none Hospital

Kenneth 12/31/2016 none North Big Horn Ferbrache PA-C 10/1/2016 No Exclusion none Hospital Plattle Valley Edwin Sheils PA- 12/31/2016 none Medical Clinic C 10/1/2016 No Exclusion none (Saratoga) Red Desert (b) (6) 12/31/2016 none Richard InstaCare (Rock Anderson PA-C 10/1/2016 No Exclusion none Springs)

Red Desert 12/31/2016 none Jonathan Said InstaCare (Rock PA-C 10/1/2016 No Exclusion none Springs) Brendan Fitzsimmons 6/30/2017 none North Big Horn MD 10/1/2016 No Exclusion 10/9/2016 Hospital Troy Caldwell North Big Horn 6/30/2017 none MD 10/1/2016 No Exclusion 10/9/2016 Hospital North Cheyenne 6/30/2017 none Family Radu Segal MD 10/1/2016 No Exclusion 6/11/2013 Medicine Family James 6/30/2017 none Medicine of Naramore MD 10/1/2016 No Exclusion 9/17/2015 Gillette

Bille Wilkerson 6/30/2017 none Family MD 10/1/2016 No Exclusion none Health(Gillette) Red Desert Darcy Turner 6/30/2017 none Instacare(Rock MD 10/1/2016 No Exclusion none Springs)

Dean Plattle Valley 6/30/2017 none Bartholomew Medical MD 10/1/2016 No Exclusion none Clinic(Saratoga) Central Wy Angelo (b) (6) 6/30/2017 none Neurology Santiago MD 10/1/2016 No Exclusion none (Casper) Denise Tuttle 6/30/2017 none MD 10/1/2016 No Exclusion 8/2/2016 Cedars Health License Disciplinary Last review date by Date of last oversite Expired Date SAM check Company Name Provider Number Action DDS visit

Optometry (b) (6) 4/1/2018 none 9/5/2017 No exclusion none Clear Image Vision Care Kirby Treat OD 4/1/2018 none 9/5/2017 No exclusion none self William Atkinson OD 4/1/2018 none 9/5/2017 No exclusion none self Wayne Hudson OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center Gary Poteet OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center Susan Lowe OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center James A Boucher OD 4/1/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center Amy Aldrich OD 4/1/2018 none 9/5/2017 No exclusion none Todd Sholey OD Family Vision Clinic (Rock Springs) 4/1/2018 none 9/5/2017 no exclusion none Richard Canestrini OD Family Vision Clinic (Rock Springs) 4/1/2018 none 9/5/2017 No exclusion none Helen D Kim OD Family Vision Clinic (Rock Springs) 4/1/2018 none 9/5/2017 No exclusion none James Hinkle OD Riverton Vision Center 4/1/2018 none 9/5/2017 No exclusion none Brian Ballard OD Riverton Vision Center 4/1/2018 none 9/5/2017 No exclusion none Christopher Frazier OD Riverton vision Center 4/1/2018 none 9/5/2017 No exclusion none Jill Miller OD Sheridan Eyecare Center 4/1/2018 none 9/5/2017 No exclusion none Samuel Hoffmann OD Sheridan Eyecare Center 4/1/2018 none 9/5/2017 No exclusion none Timothy Fehlauer OD Sheridan Eyecare Center 4/1/2018 none 9/5/2017 No exclusion none Joseph C Maycock OD Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Roger L Jordan OD Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Robert Mills OD Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Joseph L Fischer OD (b) (6) Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Melissa Younger OD Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Ashlee M Mills-Fischer OD Gillette Optometric Clinic 4/1/2018 none 9/5/2017 No exclusion none Devin Davis OD Split Rock Vision Clinic (Wheatland) 4/1/2018 none 9/5/2017 No exclusion none Daniel Perala OD New Concept Optical (Cheyenne) 3/31/2018 none 9/5/2017 No exclusion none Michelle Chaney OD Eye Center Of Northern Colo 3/31/2018 none 9/5/2017 No exclusion none Nathan Rains OD Eye Center Of Northern Colo 3/31/2018 none 9/5/2017 No exclusion none Natalie Santelli OD Eye Center Of Northern Colo 3/31/2018 none 9/5/2017 No exclusion none Benjamin Marske OD Eye Center Of Northern Colo 3/31/2018 none 9/16/2016 No exclusion none Marcelo Saldivia OD Eye Center Of Northern Colo 4/1/2018 none 9/5/2017 No exclusion none Benjamin Kister OD Kister Eyecare (Riverton) 4/1/2018 none 9/5/2017 No exclusion none Kristopher Hubbard OD Cheyenne Eye Clinic 4/1/2018 none 9/5/2017 No exclusion none James Bell OD Basin Vsion Center-Cody 4/1/2018 none 9/5/2017 No exclusion none Jonathan Hartley OD Basin Vsion Center-Cody

License Disciplinary Date of last oversite Expired Date Last review Date DDS SAM check Company Name Opthamology Number Action visit 6/30/2018 none 9/5/2017 No exclusion 8/13/2013 Ronald Gibson MD (b) (6) Central Wyoming Eye Clinic 6/30/2018 (b) (6) 9/5/2017 No exclusion none William Ramsay MD Teton Eye Clinic 6/30/2018 none 9/5/2017 No exclusion none Snowy Range Vision Center Gary Foster MD 6/30/2018 none 9/5/2017 No exclusion none Anne Miller MD Cheyenne Eye Clinic 6/30/2018 none 9/5/2017 No exclusion none Kyle Piwonka MD Cheyenne Eye Clinic 6/30/2018 none 9/5/2017 No exclusion none Zachary D Pearce DO (b) (6) Cheyenne Eye Clinic 6/30/2018 none 9/5/2017 No exclusion none James Cole MD Cheyenne Eye clinic 4/30/2018 none 9/5/2017 No exclusion none Chet Reistad MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Randall W Smith MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none William A Shachtman MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Arthur Korotkin MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Kent Crews MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Patrick Arnold MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Kent Bashford MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Mattew Robinson MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Josh Apple MD Eye Center Of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Jason Mayer MD Eye Center of Northern Colo 4/30/2018 none 9/5/2017 No exclusion none Adam McLaughlin MD Eye Center of Northern Colo 4/30/2018 (b) (6) 9/5/2017 No exclusion none Karl Olsen MD Eye Center of Northern Colo 10/1/2018 none 9/5/2017 No exclusion none Judson C Martin MD Oregon Trial Eye Center 10/1/2018 none 9/5/2017 No exclusion none Thomas J Roussel MD Oregon Trial Eye Center 10/1/2018 none 9/5/2017 No exclusion none Shawna R Collier MD Oregon Trial Eye Center 3/1/2018 none 9/5/2017 No exclusion none J Geoffrey Slingsby MD Slingsby Eye Care (Rapid City) 1/31/2018 none 9/5/2017 No exclusion none Kim Taylor MD Moran eye center (Salt Lake City)

Not using any longer 4/1/2018 none 9/5/2017 No exclusion none David Halsey OD Split Rock Vision Clinic (Wheatland) Disciplinary Last review date Date of last Expired Date SAM check Provider License Number Action by DDS oversite visit Company Name

none 9/15/2017 No exclusion none High country Michael Alley Audiology (Rock AuD (b) (6) 12/31/2017 Springs/Lander) none 9/15/2017 No exclusion none Audiology Center Jan Pierson AuD 12/31/2017 INC (Cheyenne) Thomas Laya Wyo Audiology & none 9/15/2017 No exclusion none AuD 12/31/2017 Hearing Big Horn Basin Ben Koperski none 9/15/2017 No exclusion none Hearing INC AuD 12/31/2017 (Cody) Sheridan Ear none 9/15/2017 No exclusion none Susan Roller AuD 12/31/2017 Nose & Throat Wyoming none 9/15/2017 No exclusion none Otolaryngology Cheryl Drost AuD 12/31/2017 PC Rehder Balance Tracy Hayden none 9/15/2017 No exclusion none & Hearing Clinic AuD 2/1/2017 (Billings) Rehder Balance Crystal Dvorak none 9/15/2017 No exclusion none & Hearing Clinic AuD 2/1/2017 (Billings)

Douglas Rehder none 9/15/2017 No exclusion none Rehder Hearing AuD 2/1/2017 Clinic(Billing, MT)

Lauren Gunn none 9/15/2017 No exclusion none Harvard Park AuD 3/31/2018 Hearing (Denver) Meghan Safko (b) (6) none 9/15/2017 No exclusion none Harvard Park Aud 3/31/2018 Hearing (Denver)

Casey Amann none 9/15/2017 No exclusion none Harvard Park AuD 3/31/2018 Hearing (Denver)

none 9/15/2017 No exclusion none Harvard Park Elissa Jodon Aud 3/31/2018 Hearing (Denver) Mountian View none 9/15/2017 No exclusion none Audiology Kerr McDill AuD 12/31/2017 (Casper)

Mountain Plains none 9/15/2017 No exclusion none Norman Audiology (Rapid Sorensen Aud 6/1/2017 city, SD) St. John's Audiology & none 9/15/2017 No exclusion none Rosanne Prince Hearing Aids AuD 12/31/2017 (Jackson)

No longer using

Ogden Audiology none 9/15/2016 No exclusion none Stephen Harward Services(Ogden AuD (b) (6) 5/31/2017 UT) Ogden Audiology none 9/15/2016 No exclusion none Services(Ogden *also in Wy 12/31/2016 UT) *never got ces # # # # back # # Sweetwater none 9/15/2016 No exclusion none Brandi Crockett (b) (6) Audiology/ AuD 12/31/2016 Ogden Audiology *same as # # # # Harward # #

Brant none 9/15/2016 No exclusion none Brant Audiology Christensen AuD 12/31/2016 LLC (Cheyenne) *never got ces back # # # # # #

none 9/15/2016 No exclusion None Brant Audiology Ruby Zubrod AuD 12/31/2016 LLC (Cheyenne)

*see Christensen # # # # # # Samantha Wagner Yung Brant Audiology AuD 12/31/2017 none 9/15/2016 No exclusion none LLC (Cheyenne)

*see Christensen # # # # # # UW-Div of Amy Weaver none 9/15/2016 No exclusion none Communication AuD 12/31/2016 Disorders * no using at this # # # # point # # UW-Div of Theresa Garcia none 9/15/2016 No exclusion none Communication AuD 12/31/2016 Disorders * no using at this # # # # point # # Disciplinary Last review date by Date of last oversite Company Name Provider License Number Expired Date Action DDS SAM check visit No none Haley Perl SLP (casper) 12/31/2018 none 9/11/2017 Exclusion works for Shriver Therapy Group (b) (6) No unknown Carla Shriver SLP (Casper) 12/31/2017 none 9/11/2017 Exclusion The Shriver Therapy Group No unknown Rebecca Crane SLP (riverton) 12/31/2017 none 9/11/2017 Exclusion Own company/ St.Stephen'S school Dori Samson SLP (Consult/ CE No unknown Provider) 12/31/2017 none 9/11/2017 Exclusion Own company/ School Dist

No longer using Margaret Gerrish/ Margaret Lapsed No unknown Williams SLP 12/31/2008 none 9/15/2016 Exclusion Sage View Rehab services No unknown Susan Nannenga SLP (was in Cody) 12/31/2016 none 9/15/2016 Exclusion Progressive Therapy Services (ND) No Child Development cntr/ Sch Dist./ unknown Anne Baures SLP (Sheridan) 12/31/2016 none 9/15/2016 Exclusion Own

*never answered voice messages No unknown Jane Johnston SLP (Saratoga) 12/31/2016 none 9/15/2016 Exclusion Local Therapy LLC License Disciplinary Date of last oversite Company Name Expired Date Last review date by DDS Provider Number Action SAM check visit Michael Martin MD (b) (6) 6/30/2018 (b) (6) 9/11/2017 No Exclusion unknown Doc Martin's Ear Nose & Throat Scott Bateman MD 6/30/2018 none 9/11/2017 No Exclusion unknown Sheridan Ear, Nose, & Throat Joseph Vigneri MD Wyoming Otholaryngology none 9/11/2017 unknown (retired) 6/30/2018 No Exclusion Eugene Podrazik MD 6/30/2018 none 9/11/2017 No Exclusion unknown Wyoming Otholaryngology David (cope) Norcross Wyoming Otholaryngology none 9/11/2017 unknown MD 6/30/2018 No Exclusion Colby Butler APRN 12/31/2018 none 9/15/2017 No Exclusion unknown Wyoming Otholaryngology Last review date by Sign Lang. Interpreter's Location Business name SAM check DDS Copeland Sign Catherine Copeland Billings Language No Exclusion 9/15/2017 Gail Schenfisch Casper self No Exclusion 9/15/2017

Last review date by Spanish Interpreter's Location Business Name SAM check DDS Nohora Groce Casper Self No Exclusion 9/15/2017 Ian Caldon Cheyenne Self No Exclusion 9/15/2017 Ernest Hastey Cheyenne Self No Exclusion 9/15/2017 Alda Banda Gillette Self No Exclusion 9/15/2017 Vida Sandez Jackson El Puente No Exclusion 9/15/2017 John (Tom)Duncan Riverton Self No Exclusion 9/15/2017 Bea Torrez Worland Self No Exclusion 9/15/2017 Last review date by Hospital (Wyoming only) Location SAM check DDS Johnston Co healthCare Center Buffalo No Exclusion 9/11/2017 Wyoming Medical Center Casper No Exclusion 9/11/2017 Cheyenne Regional Medical Center Cheyenne No Exclusion 9/11/2017 West Park Hospital Cody No Exclusion 9/11/2017 Memorial Hos Of Converse County Douglas No Exclusion 9/11/2017 Evanston Regional Hosital Evanston No Exclusion 9/11/2017 Wyoming State Hospital (WY Department of Health) Evanston No Exclusion 9/11/2017 Campbell Co Memorial Hospital Gillette No Exclusion 9/11/2017 South Big Horn County Hospital Greybull/Basin No Exclusion 9/11/2017 St. John's Medical Center Jackson No Exclusion 9/11/2017 Lander Valley Medical Center (Sagewest Health Care) Lander No Exclusion 9/11/2017 Ivinson Memorial Hospital Laramie No Exclusion 9/11/2017 North Big Horn Hospital Lovell No Exclusion 9/11/2017 Niobrara Health and Life Center Lusk No Exclusion 9/11/2017 Weston County Health Services Newcastle No Exclusion 9/11/2017 Memorial Hospital of Carbon County Rawlins No Exclusion 9/11/2017 Riverton County Hospital(SageWest Health Care) Riverton No Exclusion 9/11/2017

Memorial Hospital of Sweetwater County Rock Springs No Exclusion 9/11/2017 Memorial Hospital of Sheridan County Sheridan No Exclusion 9/11/2017 Crook County Memorial Hospital Sundance No Exclusion 9/11/2017 Hot Springs County Memorial Hospital Thermopolis No Exclusion 9/11/2017 Community Hosptial(Banner Health) Torrington No Exclusion 9/11/2017 Platte County Memorial Hospital (Banner Health) Wheatland No Exclusion 9/11/2017 Washakie County Memorial Hospital Worland No Exclusion 9/11/2017 Powell Valley Healthcare Powell No Exclusion 9/11/2017 Star Valley Medical Center Afton No Exclusion 9/11/2017 Wyoming Behavioral Institute Casper No Exclusion 9/11/2017 Elkhorn Valley Rehab Casper No Exclusion 9/11/2017 South Lincoln Medical Center Kemmerer No Exclusion 9/11/2017 Aspen Mountain Medical Center Rock Springs No Exclusion 9/11/2017 Summit Medical Center Casper No Exclusion 9/11/2017 Mountain View Regional Hospital Casper No Exclusion 9/11/2017 License Last review date by Provider Number Expired Date Disciplinary Action DDS SAM check

Cheyenne Radiology Group David Michael Kellam MD (b) (6) 6/30/2018 none 9/11/2017 No Exlusion James G Hubbard MD 6/30/2018 none 9/11/2017 No Exlusion John Wright MD 6/30/2018 none 9/11/2017 No Exlusion Scott Hayden MD 6/30/2018 none 9/11/2017 No Exlusion William D Ketcham MD 6/30/2018 none 9/11/2017 No Exlusion Daniel R Possehn DO 6/30/2018 none 9/11/2017 No Exlusion Eric Hoyer MD 6/30/2018 none 9/11/2017 No Exlusion Mark Howshar MD 6/30/2018 none 9/11/2017 No Exlusion

BlackRock Imaging Company # none 9/11/2017 No Exlusion * Blackrock uses same Cheyenne Radiologist

Casper Medical Imaging Geoffrey Smith MD 6/30/2018 none 9/11/2017 No Exlusion Daniel Sulser MD 6/30/2018 none 9/11/2017 No Exlusion Michael Sloan MD 6/30/2018 none 9/11/2017 No Exlusion Charles Bowkley MD 6/30/2018 none 9/11/2017 No Exlusion Michael Flaherty MD 6/30/2018 none 9/11/2017 No Exlusion Joseph McGinley MD 6/30/2018 none 9/11/2017 No Exlusion Seth Iverson MD 6/30/2018 none 9/11/2017 No Exlusion Frederick Cubin MD 6/30/2018 none 9/11/2017 No Exlusion

Wyoming Cardiopulmony (no longer using) multiple lic. multiple lic. none 9/11/2017 No Exlusion Cheyenne Childrens' Clinic (no longer using) multiple lic. multiple lic. none 9/11/2017 No Exlusion Cheyenne IMG (No longer using) multiple lic. multiple lic. none 9/11/2017 No Exlusion AMCE (never worked out) multiple lic. multiple lic. none 9/11/2017 No Exlusion

UWFP Cheyenne (no longer using) multiple lic. multiple lic. none 9/11/2017 No Exlusion Jackson Pediatrics multiple lic. multiple lic. none 9/11/2017 No Exlusion SAM Link https://www.sam.gov/portal/SAM/#1

Wyo Board of Medicine http://wyomedboard.wyo.gov/

Wyoming Board of Nursing https://nursing-online.state.wy.us/

Wyoming Board of Speech Pathology & Audiology http://speech.wyo.gov/

Wyoming Board of Examiners in Optometry http://optometry.wyo.gov/

Wyoming Board of Psychology https://sites.google.com/a/wyo.gov/psychology/public/verification