{"text_format":"1","workbook":"xlsx","n_sheets":7,"sheets":["Adds for Medicaid Plans","Addl Networks Form","Provider Roster","Provider Services","Facility Services","Dropdowns","Medicare Taxonomy Crosswalk"],"not_rendered":{"charts":0,"images":1,"macros":1,"external_links":0,"defined_names":5,"comments":1,"pivot_tables":0},"unopened":[],"bounds":{"document_bytes":16777216,"sheet_cells":100000,"rows_first":2000,"rows_last":500,"rows_between":2000,"halvings":0,"cell_chars":16384,"cell_head_chars":4096},"cells_cut":0,"cells_raw":0,"read":"whole","date_system":"1900"}

{"sheet":"Adds for Medicaid Plans","index":0,"n_rows":3,"n_cols":74,"rows_kept":3,"cut":false,"hidden":true,"merged":[[0,0,0,9]]}
["NOTE:  The follow list of practitioners may or may not already have your Medicaid products loaded.  I am resubmitting them with their Medicaid Legacy number to insure the products have been loaded.  Future monthly reports will only include practitioners with newly issued Legacy ID's."]
["Submission","Effective date","PROVIDER LASTNAME","FIRSTNAME","MIDDLENAME","DEGREES","DOB","NPI","Gender","SSN","TAXONOMY","TAXONOMY_SHORTDESCRIPTION","MO MEDICAID NUMBER","MEDICARE NUMBER","PROVIDER_CAQH","SCP/PCP","EDUCATION NAME","EDUCATION GRAD DATE","PRIMARYSPECIALTY","SECONDARYSPECIALTY1","SECONDARYSPECIALTY2","BOARD CERTIFIED STATUS","CERTIFIED_BOARD","BOARD AWARD DATE","BOARD EXPIRATION DATE","CERTIFIED_LIFETIME","CERTIFIED_LIFETIIME BOARD","LIFETIME CERTIFICATION DATE","MO_LICENSE","MO LICENSE EXPIRATION","MO DEA","DEA EXPIRATION","PRIMARY ADDRESSLINE1","PRIMARY ADDRESSLINE2","PRIMARY CITY","PRIMARY STATE","PRIMARY ZIPCODE","PRIMARY PHONE","PRIMARY FAX","TMC Group NPI","ALTERNATE ADDRESS1","ALTERNATE CITY1","ALTERNATE STATE1","ALTERNATE ZIPCODE1","ALTERNATE PHONE1","ALTERNATE FAX1","ALTERNATE ADDRESS2","ALTERNATE CITY2","ALTERNATE STATE2","ALTERNATE ZIPCODE2","ALTERNATE PHONE2","ALTERNATE FAX2","BILLING ADDRESS","BILLING CITY","BILLING STATE","BILLING ZIPCODE","BILLING PHONE","PROFESSIONAL LIABILITY INS","INS EXPIRATION DATE","AGGREGATE LIMIT","PERCLAIM LIMIT","ALTERNATE LANGUAGES1","ALTERNATE LANGUAGES2","ORIGINAL CREDENTIAL DATE","CURRENT CREDENTIAL DATE","Supervising Physician","Supervising Specialty","Accepts Patients","Include in Directory","Delegate Group","Tax ID","Does Provider have at least Hospital Admitting Privileges  \nor Covering Arrangements\n(Y or N)","Name of Admitting Hospital Affiliation(s) or Covering Group/Provider name","Admitting Hospital Affiliation Status\nStatus is not required if Provider has covering arrangements"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Truman Medical Center, Inc.",440661018]

{"sheet":"Addl Networks Form","index":1,"n_rows":66,"n_cols":7,"rows_kept":66,"cut":false,"hidden":false,"merged":[[61,0,61,6],[62,0,62,6],[63,0,63,6],[64,0,64,6],[65,0,65,6],[60,0,60,6],[48,0,48,6],[49,0,49,6],[50,0,50,6],[51,1,51,6],[52,1,52,6],[53,1,53,6],[54,1,54,6],[55,0,55,6],[56,0,56,6],[57,0,58,6],[59,0,59,6],[45,0,45,1],[45,3,45,6],[46,0,46,1],[46,3,46,6],[47,0,47,1],[47,3,47,6],[42,0,42,1],[42,3,42,6],[43,0,43,1],[43,3,43,6],[44,0,44,1],[44,3,44,6],[39,0,39,1],[39,3,39,6],[40,0,40,1],[40,3,40,6],[41,0,41,1],[41,3,41,6],[25,0,25,2],[26,1,26,2],[38,0,38,1],[27,1,27,2],[38,3,38,6],[28,0,28,2],[29,1,29,2],[30,1,30,2],[31,1,31,2],[32,0,32,2],[34,0,34,6],[35,0,35,6],[36,0,36,1],[36,3,36,6],[37,0,37,1],[37,3,37,6],[17,1,17,2],[18,1,18,2],[19,1,19,2],[20,1,20,2],[23,0,24,0],[23,1,24,2],[21,1,21,2],[22,1,22,2],[16,1,16,2],[14,0,15,2],[14,4,15,6],[1,0,1,6],[2,0,2,6],[4,0,4,6],[5,0,5,6],[6,0,6,6],[7,0,7,6],[8,0,8,6],[9,0,9,6],[10,0,10,6],[11,0,11,6],[12,0,12,6]]}
[]
["Currently Contracted Provider/Groups Request for Additional Networks "]
["Thank you for being an existing Blue KC network provider and showing interest in joining additional Blue KC network(s)! Blue KC is proud to partner with providers, groups and facilities that provide quality, value-based care to our members. We are selective upon the quantity and quality of providers that we add to each of our networks. At any given time, not all networks maybe open for contracting and some networks are by invitation only; therefore we have employed a network interest process. \n\nOur Process\nA committee reviews each application for completeness, what services are offered, our network needs, our anticipated needs in the coming months and other factors. If the Network Committee authorizes a provider, group or facility to join a network, the provider and/or provider group or facility will receive a letter of approval  to join additional network(s) and an amendment to your contract will be sent based on the contact information below. The effective date of being in network will be noted on the amendment. \n\nThe contract will be sent via electronic signature to the email address listed in the application. Because there is only a limited number of network offerings at any given time, Blue KC adheres to a strict due date policy, following MO law of a 30 day window for contract review, signature and return. If the contract is not returned by the specified date, the contract offer will be rescinded. The contract will specify the network(s) the provider has been offered.  Once the contract is returned to Blue KC, it is countersigned by contract management and entered in the system for claims and network configuration, which can take up to 30 days. The contract amendment effective date is future dated to allow for contract configuration and will not be effective until this date. No contracts will be backdated. Providers who bill Blue KC for services prior to the contract effective date will be processed as out of network.  No exceptions.  \n\nIf the provider or group is not selected to join our network(s), we will provide notification within 30 days of application with the reason for not contracting additional networks. Providers may reapply 6 months after the initial application date.\n\nAgain, thank you for your interest in additional networks and being a valued partner of Blue KC!"]
[]
["Additional Network Form Instructions"]
["1. Complete the applicable BLUE highlighted tabs in this workbook. The GREEN tabs are for informational purposes only."]
["2. Review the SUBMISSION CHECKLIST section of the Additional Network Form and ensure ALL forms and submissions are accounted for."]
["3. Ensure that all Individual Provider data has been reviewed and attested to in CAQH, CMS PECOS and NPPES in the last 30 days. The common data in these databases MUST MATCH."]
["4. If a contract is offered, to ensure that the contract is extended for the appropriate services, please ensure that all services on the Provider and/or Facility Services tabs have been recorded.  If applicant is a Durable Medical Equipment, Prosthetics, Orthotics Supplier (DMEPOS), the HCPCS codes that will be supplied are REQUIRED for a complete Additional Network Form. "]
["5. Ensure the office contact email and the email of the CONTRACT SIGNATOR is filled out appropriately. CONTRACTS SENT THROUGH AUTOSIGN CANNOT BE FORWARDED."]
["6. Sign and attest to the Additional Network Form."]
["7. Send all materials in one email to networkinterest@bluekc.com with the Provider/Group NPI # and Name in the Subject line. "]
["8. Update all Provider Data https://providers.bluekc.com/eForms/Form/ProviderDemographic. "]
[]
["Provider/Froup/Facility Information\n*Must Complete ALL APPLICABLE Tabs in Workbook and Credentialing Forms in Folder*",null,null,null,"Network(s) Interested in Joining\nCheck network(s) applied for"]
[]
["Group Name (dba Name)",null,null,null,"Blue Access                     ","NBACC0001"]
["Legal Business Name",null,null,null,"Blue Care HMO     ","CBCRC0001"]
["Tax ID ",null,null,null,"Blue Select","QBSLC0001"]
["Group NPI",null,null,null,"Blue Select Plus","QBSPC0001"]
["Group/Facility Specialty",null,null,null,"ACA Blue Select","QBSLC0002"]
["Group/Facility Taxonomy",null,null,null,"ACA Blue Select Plus","QBSPC0002"]
["# of Practice Locations",null,null,null,"Freedom Network      ","ZPHPF001"]
["CMS Facility & Supplier Certification\n",null,null,null,"Freedom Network Select  ","ZPHPFS01"]
[null,null,null,null,"Preferred Care Blue","JPCBC0001"]
[null,null,null,null,"ACA Preferred Care Blue","JPCBC0002"]
["Practice Administrator Name",null,null,null,"Preferred Care","HPCRC0001"]
["Practice Administrator Email",null,null,null,"Medicare Advantage HMO","MMCRADV001"]
[null,null,null,null,"Medicare Advantage HMO SPIRA","MMCRADV003"]
["Contract Signator's Name",null,null,null,"Medicare Advantage PPO","MMCRADV002"]
["Contract Signator's Title",null,null,null,"Participating Traditional HMO","PPARH0001","Required"]
["Contract Signator's Email",null,null,null,"Participating Traditional PPO","PPARC0001","Required"]
["If admitted to the network(s), the contract will be sent to this email address. This signator must be authorized to sign on behalf of the Provider, Group or Facility."]
[]
["Submission Checklist"]
["Blue KC participates in CMS' Government Programs. In participation with CMS, Blue KC follows CMS guidelines and the provider data match. All information in CAQH, PECOS and NPPES must be consistent and match; therefore, Blue KC requires that all providers or groups requesting to join our networks have reviewed, corrected and attested their provider information within the last 30 days. Provider data that is inconsistent and does not match will automatically result in denial of the additional network  form."]
["Attached a Completed Current W-9 Form",null,null,"https://www.irs.gov/pub/irs-pdf/fw9.pdf "]
["Completed the ENTIRE  additional network form in full?"]
["Completed the Facility and Provider Services Tabs of the services that are available?"]
["Has the Provider's CAQH Profile been updated within the last 30 days?",null,null,"https://proview.caqh.org/Login/Index?ReturnUrl=%2f "]
["Has the Provider's CMS PECOS Profile been updated within the last 30 days?",null,null,"https://pecos.cms.hhs.gov/pecos/login.do#headingLv1"]
["Has the Provider's NPI Registry Profile been updated within the last 30 days?",null,null,"https://nppes.cms.hhs.gov/#/"]
["If the Provider has a CLIA lab, is a copy of the certificate included?",null,null,"https://www.cdc.gov/clia/LabSearch.html"]
["If the Provider supplies or distributes DMEPOS, is a copy of the CMS certificate included?",null,null,"https://data.cms.gov/provider-data/search?theme=Supplier%20directory"]
["Attached a copy of the DMEPOS HCPCS Codes which Provider Supplies?"]
["Attested to and signed Blue KC's Standards for DMEPOS Suppliers ?"]
["If the Provider has has Advanced Diagnositc Imaging, is a copy of the FDA certificate included?",null,null,"https://www.fda.gov/radiation-emitting-products"]
["Attached a copy of Provider Chargemaster Description?"]
[]
["Attestation"]
["By signing this form, provider is acknowledging Blue KC's network requirements have been reviewed and understood. Provider attests that he/she or their designee has reviewed the additional network form and all required forms and documentation for its completeness. Provider further acknowledges that incomplete Additional Network Form will be automatically rejected and Provider will not be eligible to reapply for 6 months after the date of submission. "]
["Submitter Name"]
["Submitter Title"]
["Submitter Signature"]
["Date"]
["Please submit the completed Additional Network Form  and all completed forms to:\nnetworkinterest@BlueKC.com\nPlease note in the email subject line the Provider/Group/Facilty NPI. If your  packet includes multiple files which are larger than 25MB, please send separate emails with the email subject line stating the Provider/Group/Facilty NPI \"1 of 3.\" \nALL PROVIDER CREDENTIALING FORMS MUST BE SENT AS INDIVIDUAL EMAILS, PER INSTRUCTIONS ON THE FORM.\n"]
[]
["Timeline and Process after Submission of a COMPLETE Additional Network Form"]
[]
["An application can take up to 90 days to get the amendment completed and the network(s) configured in our payment system depending upon time of year and work load. This timeline takes into account the required timelines that must be adhered to by law."]
["1. Within 2 days, Blue KC will send a confirmation of received form"]
["2. Within 10 days, Blue KC will send a confirmation of initial review and give  3 days to return any missing documents "]
["3. Within 30 days, Blue KC's Network Committee will review network needs and if selected, process applicants through the credentialing process and notify Provider of a decision.   "]
["4. Within 10 days of network decision, if selected, Blue KC will send a contract."]
["5. Provider has 30 days to review contract and returned signed agreement to Blue KC."]
["6. After receipt of signed agreement, Blue KC will configure the contract for claims adjudication and send Welcome packet."]

{"sheet":"Provider Roster","index":2,"n_rows":13,"n_cols":47,"rows_kept":13,"cut":false,"hidden":false,"merged":[[0,2,0,16],[1,0,1,18],[4,0,4,6],[5,2,5,3],[5,4,5,6],[5,8,5,11],[5,13,5,15],[6,2,6,3],[6,4,6,6],[6,8,6,11],[6,13,6,15],[7,2,7,3],[7,4,7,6],[7,8,7,11],[7,13,7,15],[8,8,8,11],[8,13,8,15],[9,2,9,3],[9,4,9,6],[9,8,9,11],[9,13,9,16],[10,2,10,3],[10,4,10,6],[11,0,11,6],[8,2,8,3],[8,4,8,6]]}
[]
["Provider/Group Network Interest Form Provider Data"]
["*Please update your provider data if needed below"]
[]
[]
[null,null,"Group Name (dba Name)",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,null,null,"Additional Group Services",null,null,null,"Y/N",null,null,null,"Certification #"]
["Form Legend",null,"Legal Business Name",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,null,null,"Does Practice Have a Lab? (Y/N)",null,null,null,null,"If Yes, CLIA Certification #"]
["ADD",null,"Tax ID ",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,null,null,"Is Practice a DMEPOS Supplier? (Y/N)",null,null,null,null,"If Yes, Add Certification # & Complete Tab DMEPOS Supplier MASTER"]
["CHANGE ",null,"Group NPI",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,null,null,"Does Practice Have Advanced Diagnostic Imaging? (Y/N)",null,null,null,null,"If Yes, FDA Certification #"]
["DELETE",null,"Practice Administrator Name",null,{"$f":"#REF!","v":{"$error":"#REF!"}},null,null,null,"Administer Injectable Drugs (Y/N)"]
[null,null,"Practice Administrator Email",null,{"$f":"#REF!","v":{"$error":"#REF!"}}]
[]
["Add/Change/Delete\n\n(Please See Color Code Legend Above)","Blue KC Provider ID #\n\n(Exisitng Providers Only)","Provider\nHas \nPreviously \nBeen\nCredentialed\nWith \nBlue KC\n\n(Y/N)","Individual Provider NPI","Provider Last Name","Provider First Name","Middle Name","Provider Suffix","Degree Type","Gender","CAQH #","DEA \nLicense #","Primary \nPracticing Speciality","Primary \nProvider \nTaxonomy \nCode","Secondary \nPracticing Speciality","Secondary \nProvider \nTaxonomy \nCode","Provider Type\n\nP = PCP\nS = Specialist\nH = Hospitalist","Is Provider Accepting New Patients?\n\n(Y/N)","Patient Gender Restrictions\n\nM = Male\nF = Female","Patient Age Restrictions\n\n0 = < 18 Yrs\n1 = > 18 Yrs","Provider\nState\nLicense #","Provider\nLicense \nExpiration Date","Provider License State","Supervising Physician Name\n\n(Midlevels Only)","Supervising\nPhysician NPI\n\n(Midlevels Only)","Supervising\nPhysician Specialty\n\n(Midlevels Only)","Provider\nMedicare ID #\n\n(PTAN)","In the Last 2 Years, Has Provider Opted Out of Medicare?\n\n(Y/N)","Has Provider Been Sanctioned By the Office of the Inspector General?\n\n(Y/N)","Practice Address Type\n\nP = Primary Practice\nA = Additional Practice","Is Location Handicap Accessible?\n\n(Y/N)","Practice Address 1","Practice \nAddress 2 (Ste #)","Practice City","Practice State","Practice Zip","Practice County","Practice Phone","Practice Fax","Physician Hospital Affiliation 1","Physician Hospital Affiliation 2","Physician Hospital Affiliation 3","Physician Hospital Affiliation 4","Physician Hospital Affiliation 5","Physician Ambulatory Surgical Center Affiliation 1","Physician Ambulatory Surgical Center Affiliation 2","Physician Ambulatory Surgical Center Affiliation 3"]

{"sheet":"Provider Services","index":3,"n_rows":38,"n_cols":26,"rows_kept":38,"cut":false,"hidden":false,"merged":[[1,0,1,28],[4,1,4,4],[5,0,5,4],[4,7,4,10],[5,6,5,10],[4,13,4,16],[5,12,5,16],[4,19,4,22],[5,18,5,22],[4,25,4,28],[5,24,5,28],[2,0,2,28]]}
[]
["Provider/Group Services"]
["*Please specify services available at each Location by inserting the street address in the BLUE shaded area.  "]
[]
["Location 1",null,null,null,null,null,"Location 1",null,null,null,null,null,"Location 1",null,null,null,null,null,"Location 1",null,null,null,null,null,"Location 1"]
["Services ",null,null,null,null,null,"Services ",null,null,null,null,null,"Services ",null,null,null,null,null,"Services ",null,null,null,null,null,"Services "]
[null,"Acupuncture",null,null,null,null,null,"Acupuncture",null,null,null,null,null,"Acupuncture",null,null,null,null,null,"Acupuncture",null,null,null,null,null,"Acupuncture"]
[null,"Alcohol/Substance Abuse Counseling",null,null,null,null,null,"Alcohol/Substance Abuse Counseling",null,null,null,null,null,"Alcohol/Substance Abuse Counseling",null,null,null,null,null,"Alcohol/Substance Abuse Counseling",null,null,null,null,null,"Alcohol/Substance Abuse Counseling"]
[null,"Behavioral Counseling",null,null,null,null,null,"Behavioral Counseling",null,null,null,null,null,"Behavioral Counseling",null,null,null,null,null,"Behavioral Counseling",null,null,null,null,null,"Behavioral Counseling"]
[null,"Casting",null,null,null,null,null,"Casting",null,null,null,null,null,"Casting",null,null,null,null,null,"Casting",null,null,null,null,null,"Casting"]
[null,"Chemotherapy",null,null,null,null,null,"Chemotherapy",null,null,null,null,null,"Chemotherapy",null,null,null,null,null,"Chemotherapy",null,null,null,null,null,"Chemotherapy"]
[null,"Chronic Care Mgmt",null,null,null,null,null,"Chronic Care Mgmt",null,null,null,null,null,"Chronic Care Mgmt",null,null,null,null,null,"Chronic Care Mgmt",null,null,null,null,null,"Chronic Care Mgmt"]
[null,"CT Imaging*",null,null,null,null,null,"CT Imaging*",null,null,null,null,null,"CT Imaging*",null,null,null,null,null,"CT Imaging*",null,null,null,null,null,"CT Imaging*"]
[null,"COVID 19 Testing",null,null,null,null,null,"COVID 19 Testing",null,null,null,null,null,"COVID 19 Testing",null,null,null,null,null,"COVID 19 Testing",null,null,null,null,null,"COVID 19 Testing"]
[null,"COVID 19 Vaccination",null,null,null,null,null,"COVID 19 Vaccination",null,null,null,null,null,"COVID 19 Vaccination",null,null,null,null,null,"COVID 19 Vaccination",null,null,null,null,null,"COVID 19 Vaccination"]
[null,"Dental Services",null,null,null,null,null,"Dental Services",null,null,null,null,null,"Dental Services",null,null,null,null,null,"Dental Services",null,null,null,null,null,"Dental Services"]
[null,"Diabetes Self-Mgmt Training",null,null,null,null,null,"Diabetes Self-Mgmt Training",null,null,null,null,null,"Diabetes Self-Mgmt Training",null,null,null,null,null,"Diabetes Self-Mgmt Training",null,null,null,null,null,"Diabetes Self-Mgmt Training"]
[null,"Imaging",null,null,null,null,null,"Imaging",null,null,null,null,null,"Imaging",null,null,null,null,null,"Imaging",null,null,null,null,null,"Imaging"]
[null,"Infusion Therapy",null,null,null,null,null,"Infusion Therapy",null,null,null,null,null,"Infusion Therapy",null,null,null,null,null,"Infusion Therapy",null,null,null,null,null,"Infusion Therapy"]
[null,"Laboratory*",null,null,null,null,null,"Laboratory*",null,null,null,null,null,"Laboratory*",null,null,null,null,null,"Laboratory*",null,null,null,null,null,"Laboratory*"]
[null,"Mammography*",null,null,null,null,null,"Mammography*",null,null,null,null,null,"Mammography*",null,null,null,null,null,"Mammography*",null,null,null,null,null,"Mammography*"]
[null,"Massage Therapy",null,null,null,null,null,"Massage Therapy",null,null,null,null,null,"Massage Therapy",null,null,null,null,null,"Massage Therapy",null,null,null,null,null,"Massage Therapy"]
[null,"Medication Assistance Treatment",null,null,null,null,null,"Medication Assistance Treatment",null,null,null,null,null,"Medication Assistance Treatment",null,null,null,null,null,"Medication Assistance Treatment",null,null,null,null,null,"Medication Assistance Treatment"]
[null,"Mobile Provider",null,null,null,null,null,"Mobile Provider",null,null,null,null,null,"Mobile Provider",null,null,null,null,null,"Mobile Provider",null,null,null,null,null,"Mobile Provider"]
[null,"Moderate Sedation",null,null,null,null,null,"Moderate Sedation",null,null,null,null,null,"Moderate Sedation",null,null,null,null,null,"Moderate Sedation",null,null,null,null,null,"Moderate Sedation"]
[null,"MRI Imaging*",null,null,null,null,null,"MRI Imaging*",null,null,null,null,null,"MRI Imaging*",null,null,null,null,null,"MRI Imaging*",null,null,null,null,null,"MRI Imaging*"]
[null,"Nutritional Counseling",null,null,null,null,null,"Nutritional Counseling",null,null,null,null,null,"Nutritional Counseling",null,null,null,null,null,"Nutritional Counseling",null,null,null,null,null,"Nutritional Counseling"]
[null,"Occupational Therapy",null,null,null,null,null,"Occupational Therapy",null,null,null,null,null,"Occupational Therapy",null,null,null,null,null,"Occupational Therapy",null,null,null,null,null,"Occupational Therapy"]
[null,"Office Based Surgery",null,null,null,null,null,"Office Based Surgery",null,null,null,null,null,"Office Based Surgery",null,null,null,null,null,"Office Based Surgery",null,null,null,null,null,"Office Based Surgery"]
[null,"Opioid Mgmt Therapy*",null,null,null,null,null,"Opioid Mgmt Therapy*",null,null,null,null,null,"Opioid Mgmt Therapy*",null,null,null,null,null,"Opioid Mgmt Therapy*",null,null,null,null,null,"Opioid Mgmt Therapy*"]
[null,"Physical Therapy",null,null,null,null,null,"Physical Therapy",null,null,null,null,null,"Physical Therapy",null,null,null,null,null,"Physical Therapy",null,null,null,null,null,"Physical Therapy"]
[null,"Routine Eye Care",null,null,null,null,null,"Routine Eye Care",null,null,null,null,null,"Routine Eye Care",null,null,null,null,null,"Routine Eye Care",null,null,null,null,null,"Routine Eye Care"]
[null,"Smoking Cessation",null,null,null,null,null,"Smoking Cessation",null,null,null,null,null,"Smoking Cessation",null,null,null,null,null,"Smoking Cessation",null,null,null,null,null,"Smoking Cessation"]
[null,"Speech Therapy",null,null,null,null,null,"Speech Therapy",null,null,null,null,null,"Speech Therapy",null,null,null,null,null,"Speech Therapy",null,null,null,null,null,"Speech Therapy"]
[null,"Telehealth",null,null,null,null,null,"Telehealth",null,null,null,null,null,"Telehealth",null,null,null,null,null,"Telehealth",null,null,null,null,null,"Telehealth"]
[null,"Xrays",null,null,null,null,null,"Xrays",null,null,null,null,null,"Xrays",null,null,null,null,null,"Xrays",null,null,null,null,null,"Xrays"]
[null,"Other",null,null,null,null,null,"Other",null,null,null,null,null,"Other",null,null,null,null,null,"Other",null,null,null,null,null,"Other"]
["Denotes CMS Network Reporting-MA & ACA"]

{"sheet":"Facility Services","index":4,"n_rows":67,"n_cols":12,"rows_kept":67,"cut":false,"hidden":false,"merged":[[4,11,4,13],[1,0,1,13],[5,0,5,4],[5,6,5,8],[5,10,5,13],[4,1,4,4],[4,7,4,8],[2,0,2,13]]}
[]
["Facility/Hospital Services"]
["*Please specify services available at each Location by inserting the street address in the YELLOW shaded area. If more than 1 Facility Location, please specify each Facility Location under the NPI & TIN noted by adding the street address in the yellow highlighted area. If more than 1 facility and additional boxes are needed, please add the additional locations as needed. "]
[]
["Location 1",null,null,null,null,null,"Location 1",null,null,null,"Location 1"]
["Hospital or Facility Services",null,null,null,null,null,"Ambulatory Surgery Center Services",null,null,null,"Diagnostic Imaging Center Services*"]
[null,"Air Ambulance ",null,null,null,null,null,"Bariatric",null,null,null,"CT-Angiography Imaging (CTA)"]
[null,"Ambulance",null,null,null,null,null,"ENT",null,null,null,"CT Imaging"]
[null,"Arthritis Treatment Center",null,null,null,null,null,"Gastrointestinal",null,null,null,"Digital Mammography*"]
[null,"Arthroscopy",null,null,null,null,null,"General Surgery",null,null,null,"DEXA "]
[null,"Bariatric Surgery",null,null,null,null,null,"Gynecological",null,null,null,"Fluoroscopy"]
[null,"Blood Bank",null,null,null,null,null,"Neurology/Spine",null,null,null,"Mammography*"]
[null,"Burn ICU",null,null,null,null,null,"Ophthalmology",null,null,null,"MRI Imaging"]
[null,"Cardiac Catheterization",null,null,null,null,null,"Oral Surgery",null,null,null,"MRI Imaging-Angiography"]
[null,"Cardiac ICU",null,null,null,null,null,"Orthopedics",null,null,null,"PET Scan Imaging"]
[null,"Cardiac Rehab",null,null,null,null,null,"Pain Management",null,null,null,"SPECT Imaging"]
[null,"Cardiac Surgery",null,null,null,null,null,"Plastic Surgery",null,null,null,"Ultrasound"]
[null,"Carotid Stenting",null,null,null,null,null,"Podiatry",null,null,null,"Xray"]
[null,"Coronary Interventions",null,null,null,null,null,"Urology"]
[null,"Critical Care-ICU",null,null,null,null,null,"Vascular"]
[null,"CT-Angiography Imaging (CTA)*",null,null,null,null,null,"Other (Please Specifiy)"]
[null,"CT Imaging*"]
[null,"Diagnostic Radiology"]
[null,"Dialysis",null,null,null,null,"* Denotes Licensure Required"]
[null,"Digital Mammography*",null,null,null,null,"Denotes CMS Network Reporting-MA & ACA"]
[null,"EEG"]
[null,"Electrophysiology"]
[null,"Emergency Dept"]
[null,"Heart Transplant"]
[null,"Home Infusion"]
[null,"Hospice"]
[null,"Hospital Surgical Services"]
[null,"Hyperbaric Oxygen "]
[null,"Infusion/Chemotherapy"]
[null,"Inpatient Psychiatric Services"]
[null,"Inpatient Rehabilitation Services"]
[null,"Intensity Modulated Radiation Therapy (IMRT)"]
[null,"Joint Replacement"]
[null,"Kidney Transplant"]
[null,"Laboratory"]
[null,"Lithotripsy"]
[null,"Liver Transplant"]
[null,"Lung Transplant"]
[null,"Mammography*"]
[null,"MRI Imaging*"]
[null,"MRI Imaging-Angiography*"]
[null,"Neonatal ICU"]
[null,"Observation"]
[null,"Obstetrics"]
[null,"Occupational Therapy"]
[null,"Open Heart Surgery"]
[null,"Opioid Treatment Therapy Program"]
[null,"Pancreas Transplant"]
[null,"Pediatric ICU"]
[null,"PET Scan Imaging*"]
[null,"Physical Therapy"]
[null,"Radiation Therapy"]
[null,"Radiosurgery"]
[null,"Robotic Surgery"]
[null,"Sleep Study"]
[null,"SPECT Imaging*"]
[null,"Speech Therapy"]
[null,"Spine Surgery"]
[null,"Trauma Center"]
[null,"Vascular Intervention"]
[null,"Vasculary Surgery"]
[null,"Wound Care"]

{"sheet":"Dropdowns","index":5,"n_rows":555,"n_cols":45,"rows_kept":555,"cut":false,"hidden":true,"merged":[]}
["Provider\nHas \nPreviously \nBeen\nCredentialed\nWith \nBlue KC\n\n(Y/N)","Individual Provider NPI","Provider Last Name","Provider First Name","Middle Name","Provider Suffix","Degree Type","Gender","CAQH #","DEA \nLicense #","Practicing Speciality","Provider \nTaxonomy \nCode","Provider Type\n\nP = PCP\nS = Specialist\nH = Hospitalist","Is Provider Accepting New Patients?\n\n(Y/N)","Patient Gender Restrictions\n\nM = Male\nF = Female","Patient Age Restrictions\n\n0 = < 18 Yrs\n1 = > 18 Yrs","Provider\nState\nLicense #","Provider\nLicense \nExpiration Date","Provider License State","Supervising Physician Name\n\n(Midlevels Only)","Supervising\nPhysician NPI\n\n(Midlevels Only)","Supervising\nPhysician Specialty\n\n(Midlevels Only)","Provider\nMedicare ID #\n\n(PTAN)","In the Last 2 Years Has Provider Opted Out of Medicare?\n\n(Y/N)","Practice Address Type\n\nP = Primary Practice\nA = Additional Practice","Is Location Handicap Accessible?\n\n(Y/N)","Practice Address 1","Practice \nAddress 2 (Ste #)","Practice City","Practice State","Practice Zip","Practice County","Practice Phone","Practice Fax","Hospital Affiliation 1","Hospital Affiliation 2","Hospital Affiliation 3","Hospital Affiliation 4","Hospital Affiliation 5","Ambulatory Surgical Center Affiliation 1","Ambulatory Surgical Center Affiliation 2","Ambulatory Surgical Center Affiliation 3",null,"Is Provider a?","Add Change Delete"]
["Yes",null,null,null,null,null,null,"M",null,null,null,"208D00000X","P","Yes","M",0,null,null,"KS",null,null,null,null,"Yes","P","Yes",null,null,null,null,null,null,null,null,"AdventHealth","AdventHealth","AdventHealth","AdventHealth","AdventHealth","ADS Surg Ctr","ADS Surg Ctr","ADS Surg Ctr",null,"Ambulatory Surgical Center"]
["No",null,null,null,null,null,null,"F",null,null,null,"208600000X","S","No","F",1,null,null,"MO",null,null,null,null,"No","A","No",null,null,null,null,null,null,null,null,"Allen Cnty Hosp","Allen Cnty Hosp","Allen Cnty Hosp","Allen Cnty Hosp","Allen Cnty Hosp","AdventHealth-Lenexa","AdventHealth-Lenexa","AdventHealth-Lenexa",null,"CLIA Lab"]
[null,null,null,null,null,null,null,null,null,null,null,"2086H0002X","H",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Anderson Cnty Hosp","Anderson Cnty Hosp","Anderson Cnty Hosp","Anderson Cnty Hosp","Anderson Cnty Hosp","AdventHealth-Prairie","AdventHealth-Prairie","AdventHealth-Prairie",null,"Comprehensive OP Rehab Facility (CORF)"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0120X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Atchison Hosp","Atchison Hosp","Atchison Hosp","Atchison Hosp","Atchison Hosp","Ascentist ASC","Ascentist ASC","Ascentist ASC",null,"Dialysis Facility"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0122X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Bates Cnty Memorial","Bates Cnty Memorial","Bates Cnty Memorial","Bates Cnty Memorial","Bates Cnty Memorial","Beacon ASC","Beacon ASC","Beacon ASC",null,"Durable Medical Equipment Supplier"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0105X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Belton Regional (HCA)","Belton Regional (HCA)","Belton Regional (HCA)","Belton Regional (HCA)","Belton Regional (HCA)","Blue Ridge Surg Ctr","Blue Ridge Surg Ctr","Blue Ridge Surg Ctr",null,"Federally Qualified Health Center"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0102X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Bothwell Reg HC","Bothwell Reg HC","Bothwell Reg HC","Bothwell Reg HC","Bothwell Reg HC","Briarcliff Surg Ctr","Briarcliff Surg Ctr","Briarcliff Surg Ctr",null,"Home Health Agency"]
[null,null,null,null,null,null,null,null,null,null,null,"2086X0206X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Cameron Reg Med Ctr","Cameron Reg Med Ctr","Cameron Reg Med Ctr","Cameron Reg Med Ctr","Cameron Reg Med Ctr","Cedar Oaks Surg Ctr","Cedar Oaks Surg Ctr","Cedar Oaks Surg Ctr",null,"Hospice"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0127X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Carroll Cnty (STL)","Carroll Cnty (STL)","Carroll Cnty (STL)","Carroll Cnty (STL)","Carroll Cnty (STL)","Centerpoint ASC","Centerpoint ASC","Centerpoint ASC",null,"Hospital"]
[null,null,null,null,null,null,null,null,null,null,null,"2086S0129X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Centerpoint (HCA)","Centerpoint (HCA)","Centerpoint (HCA)","Centerpoint (HCA)","Centerpoint (HCA)","College Park Endo","College Park Endo","College Park Endo",null,"LTACH"]
[null,null,null,null,null,null,null,null,null,null,null,"208G00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Children’s Mercy","Children’s Mercy","Children’s Mercy","Children’s Mercy","Children’s Mercy","Creekwood Surg Ctr","Creekwood Surg Ctr","Creekwood Surg Ctr",null,"Occupational Therapist"]
[null,null,null,null,null,null,null,null,null,null,null,"204F00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Community-Fairfax","Community-Fairfax","Community-Fairfax","Community-Fairfax","Community-Fairfax","Deer Creek Surg Ctr","Deer Creek Surg Ctr","Deer Creek Surg Ctr",null,"OP Diabetes Self Management Trainer"]
[null,null,null,null,null,null,null,null,null,null,null,"208C00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ellett Memorial (STL)","Ellett Memorial (STL)","Ellett Memorial (STL)","Ellett Memorial (STL)","Ellett Memorial (STL)","Discover Vision-Leawd","Discover Vision-Leawd","Discover Vision-Leawd",null,"Orthotic & Prosthetic Supplier"]
[null,null,null,null,null,null,null,null,null,null,null,"207T00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Excelsior Springs","Excelsior Springs","Excelsior Springs","Excelsior Springs","Excelsior Springs","Endoscopic Imag Ctr","Endoscopic Imag Ctr","Endoscopic Imag Ctr",null,"Physical Therapist"]
[null,null,null,null,null,null,null,null,null,null,null,"204E00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Fitzgibbon Hosp","Fitzgibbon Hosp","Fitzgibbon Hosp","Fitzgibbon Hosp","Fitzgibbon Hosp","Epic Surg Ctr","Epic Surg Ctr","Epic Surg Ctr",null,"Portable Xray Supplier"]
[null,null,null,null,null,null,null,null,null,null,null,"207X00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Golden Valley","Golden Valley","Golden Valley","Golden Valley","Golden Valley","Eye Surg Ctr North","Eye Surg Ctr North","Eye Surg Ctr North",null,"Rehab"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0114X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Harrison Cnty","Harrison Cnty","Harrison Cnty","Harrison Cnty","Harrison Cnty","Heart of America ASC","Heart of America ASC","Heart of America ASC",null,"Rural Health Clinic"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0004X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Hedrick Med (STL)","Hedrick Med (STL)","Hedrick Med (STL)","Hedrick Med (STL)","Hedrick Med (STL)","Headache & Pain Ctr","Headache & Pain Ctr","Headache & Pain Ctr",null,"Skilled Nursing Facility"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0106X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"KC Orthopaedic Inst","KC Orthopaedic Inst","KC Orthopaedic Inst","KC Orthopaedic Inst","KC Orthopaedic Inst","KU Eye Surg","KU Eye Surg","KU Eye Surg",null,"Speech Language Pathologist"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0117X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"KU Medical Ctr","KU Medical Ctr","KU Medical Ctr","KU Medical Ctr","KU Medical Ctr","KU Med West","KU Med West","KU Med West"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0801X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Lafayette Reg (HCA)","Lafayette Reg (HCA)","Lafayette Reg (HCA)","Lafayette Reg (HCA)","Lafayette Reg (HCA)","KU ASC-Indian Creek","KU ASC-Indian Creek","KU ASC-Indian Creek"]
[null,null,null,null,null,null,null,null,null,null,null,"207XP3100X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Lawrence Memorial","Lawrence Memorial","Lawrence Memorial","Lawrence Memorial","Lawrence Memorial","Lawrence Surg Ctr","Lawrence Surg Ctr","Lawrence Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0005X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Lees Summit (HCA)","Lees Summit (HCA)","Lees Summit (HCA)","Lees Summit (HCA)","Lees Summit (HCA)","Liberty Cataract Ctr","Liberty Cataract Ctr","Liberty Cataract Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"208200000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Liberty Hospital","Liberty Hospital","Liberty Hospital","Liberty Hospital","Liberty Hospital","Mercury Surg Ctr","Mercury Surg Ctr","Mercury Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"2082S0099X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Menorah (HCA)","Menorah (HCA)","Menorah (HCA)","Menorah (HCA)","Menorah (HCA)","Metro Spine & Pain","Metro Spine & Pain","Metro Spine & Pain"]
[null,null,null,null,null,null,null,null,null,null,null,"2082S0105X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Miami Cnty (Olathe)","Miami Cnty (Olathe)","Miami Cnty (Olathe)","Miami Cnty (Olathe)","Miami Cnty (Olathe)","Mid America Kidney","Mid America Kidney","Mid America Kidney"]
[null,null,null,null,null,null,null,null,null,null,null,"207K00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mosaic Life Care","Mosaic Life Care","Mosaic Life Care","Mosaic Life Care","Mosaic Life Care","Mid America Surg Inst","Mid America Surg Inst","Mid America Surg Inst"]
[null,null,null,null,null,null,null,null,null,null,null,"207KA0200X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mosaic Med-Albany","Mosaic Med-Albany","Mosaic Med-Albany","Mosaic Med-Albany","Mosaic Med-Albany","Midwest Pain Mgmt","Midwest Pain Mgmt","Midwest Pain Mgmt"]
[null,null,null,null,null,null,null,null,null,null,null,"207KI0005X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Mosaic Med-Maryville","Mosaic Med-Maryville","Mosaic Med-Maryville","Mosaic Med-Maryville","Mosaic Med-Maryville","Midwest Physician ASC","Midwest Physician ASC","Midwest Physician ASC"]
[null,null,null,null,null,null,null,null,null,null,null,"207Y00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Nevada Regional","Nevada Regional","Nevada Regional","Nevada Regional","Nevada Regional","Murphy, Watson Burr","Murphy, Watson Burr","Murphy, Watson Burr"]
[null,null,null,null,null,null,null,null,null,null,null,"207YS0123X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"North KC Hospital","North KC Hospital","North KC Hospital","North KC Hospital","North KC Hospital","Moyes Eye Ctr","Moyes Eye Ctr","Moyes Eye Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207YX0602X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Olathe","Olathe","Olathe","Olathe","Olathe","Northland Eye Surg Ctr","Northland Eye Surg Ctr","Northland Eye Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207YX0905X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ovrlnd Pk Reg (HCA)","Ovrlnd Pk Reg (HCA)","Ovrlnd Pk Reg (HCA)","Ovrlnd Pk Reg (HCA)","Ovrlnd Pk Reg (HCA)","Novamed Eye Surg Ctr of OP","Novamed Eye Surg Ctr of OP","Novamed Eye Surg Ctr of OP"]
[null,null,null,null,null,null,null,null,null,null,null,"207YX0901X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Providence (Prime)","Providence (Prime)","Providence (Prime)","Providence (Prime)","Providence (Prime)","Novamed Eye Surg Ctr of Warrensburg","Novamed Eye Surg Ctr of Warrensburg","Novamed Eye Surg Ctr of Warrensburg"]
[null,null,null,null,null,null,null,null,null,null,null,"207YP0228X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Ransom (Advent)","Ransom (Advent)","Ransom (Advent)","Ransom (Advent)","Ransom (Advent)","NS Surgical Ctr","NS Surgical Ctr","NS Surgical Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207YX0007X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Research Med (HCA)","Research Med (HCA)","Research Med (HCA)","Research Med (HCA)","Research Med (HCA)","Overland Park Surg Ctr","Overland Park Surg Ctr","Overland Park Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207YS0012X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Joseph (Prime)","St Joseph (Prime)","St Joseph (Prime)","St Joseph (Prime)","St Joseph (Prime)","Physicians Surg Ctr","Physicians Surg Ctr","Physicians Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207L00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Mary’s (Prime)","St Mary’s (Prime)","St Mary’s (Prime)","St Mary’s (Prime)","St Mary’s (Prime)","Plastic Surgery Ctr of St. Joseph","Plastic Surgery Ctr of St. Joseph","Plastic Surgery Ctr of St. Joseph"]
[null,null,null,null,null,null,null,null,null,null,null,"207LA0401X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Luke’s-East","St Luke’s-East","St Luke’s-East","St Luke’s-East","St Luke’s-East","St. John Surg Ctr","St. John Surg Ctr","St. John Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207LC0200X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Luke’s-Main","St Luke’s-Main","St Luke’s-Main","St Luke’s-Main","St Luke’s-Main","St. Lukes GI Diagnostics","St. Lukes GI Diagnostics","St. Lukes GI Diagnostics"]
[null,null,null,null,null,null,null,null,null,null,null,"207LH0002X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Luke’s-North","St Luke’s-North","St Luke’s-North","St Luke’s-North","St Luke’s-North","St. Lukes South Surg Ctr","St. Lukes South Surg Ctr","St. Lukes South Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207LP2900X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St Luke’s-South","St Luke’s-South","St Luke’s-South","St Luke’s-South","St Luke’s-South","St. Lukes Surg Ctr-Shoal Creek","St. Lukes Surg Ctr-Shoal Creek","St. Lukes Surg Ctr-Shoal Creek"]
[null,null,null,null,null,null,null,null,null,null,null,"207LP3000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Truman-Hospital Hill","Truman-Hospital Hill","Truman-Hospital Hill","Truman-Hospital Hill","Truman-Hospital Hill","St. Lukes Surg Ctr-Lees Summit","St. Lukes Surg Ctr-Lees Summit","St. Lukes Surg Ctr-Lees Summit"]
[null,null,null,null,null,null,null,null,null,null,null,"207RC0000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Truman-Lakewood","Truman-Lakewood","Truman-Lakewood","Truman-Lakewood","Truman-Lakewood","Sedalia Surg Ctr","Sedalia Surg Ctr","Sedalia Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207N00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Western MO Med Ctr","Western MO Med Ctr","Western MO Med Ctr","Western MO Med Ctr","Western MO Med Ctr","Skin & Mohs Surg Ctr-Lees Summit","Skin & Mohs Surg Ctr-Lees Summit","Skin & Mohs Surg Ctr-Lees Summit"]
[null,null,null,null,null,null,null,null,null,null,null,"207NI0002X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Wright Mem (STL)","Wright Mem (STL)","Wright Mem (STL)","Wright Mem (STL)","Wright Mem (STL)","Skin & Mohs Surg Ctr-Shoal Creek","Skin & Mohs Surg Ctr-Shoal Creek","Skin & Mohs Surg Ctr-Shoal Creek"]
[null,null,null,null,null,null,null,null,null,null,null,"207ND0101X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"OTHER","OTHER","OTHER","OTHER","OTHER","Skin & Mohs Surg Ctr-Leawood","Skin & Mohs Surg Ctr-Leawood","Skin & Mohs Surg Ctr-Leawood"]
[null,null,null,null,null,null,null,null,null,null,null,"207ND0900X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"South KC Surgicenter","South KC Surgicenter","South KC Surgicenter"]
[null,null,null,null,null,null,null,null,null,null,null,"207NP0225X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St. Joseph Ctr for OP Surg","St. Joseph Ctr for OP Surg","St. Joseph Ctr for OP Surg"]
[null,null,null,null,null,null,null,null,null,null,null,"207NS0135X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"St. Marys Surg Ctr","St. Marys Surg Ctr","St. Marys Surg Ctr"]
[null,null,null,null,null,null,null,null,null,null,null,"207Q00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgery Ctr @ Liberty Hospital","Surgery Ctr @ Liberty Hospital","Surgery Ctr @ Liberty Hospital"]
[null,null,null,null,null,null,null,null,null,null,null,"207QA0401X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgery Center of Blue Valley","Surgery Center of Blue Valley","Surgery Center of Blue Valley"]
[null,null,null,null,null,null,null,null,null,null,null,"207QA0000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgery Ctr of Leawood","Surgery Ctr of Leawood","Surgery Ctr of Leawood"]
[null,null,null,null,null,null,null,null,null,null,null,"207QA0505X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgery Ctr of St Joseph","Surgery Ctr of St Joseph","Surgery Ctr of St Joseph"]
[null,null,null,null,null,null,null,null,null,null,null,"207QB0002X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgicenter of Johnson Co","Surgicenter of Johnson Co","Surgicenter of Johnson Co"]
[null,null,null,null,null,null,null,null,null,null,null,"207QG0300X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Surgicenter of KC","Surgicenter of KC","Surgicenter of KC"]
[null,null,null,null,null,null,null,null,null,null,null,"207QH0002X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The Endoscopy Ctr-East","The Endoscopy Ctr-East","The Endoscopy Ctr-East"]
[null,null,null,null,null,null,null,null,null,null,null,"207QS0010X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The Endoscopy Ctr-Liberty","The Endoscopy Ctr-Liberty","The Endoscopy Ctr-Liberty"]
[null,null,null,null,null,null,null,null,null,null,null,"207QS1201X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The Endoscopy Ctr-North","The Endoscopy Ctr-North","The Endoscopy Ctr-North"]
[null,null,null,null,null,null,null,null,null,null,null,"208VP0014X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"The Eye Surgery Ctr at the Cliffs","The Eye Surgery Ctr at the Cliffs","The Eye Surgery Ctr at the Cliffs"]
[null,null,null,null,null,null,null,null,null,null,null,"207RG0100X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Total Joint Ctr of the Northland","Total Joint Ctr of the Northland","Total Joint Ctr of the Northland"]
[null,null,null,null,null,null,null,null,null,null,null,"207R00000X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Westglen Endoscopy Center","Westglen Endoscopy Center","Westglen Endoscopy Center"]
[null,null,null,null,null,null,null,null,null,null,null,"207RA0401X",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"OTHER","OTHER","OTHER"]
[null,null,null,null,null,null,null,null,null,null,null,"207RA0000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RA0001X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RA0201X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RB0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RC0000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RI0001X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RC0200X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RE0101X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RG0100X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RG0300X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RH0000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RH0003X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RI0008X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RI0200X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RM1200X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RX0202X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RN0300X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RP1001X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RR0500X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RS0012X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RS0010X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RT0003X"]
[null,null,null,null,null,null,null,null,null,null,null,"204D00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"204C00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"2084N0400X"]
[null,null,null,null,null,null,null,null,null,null,null,"2084N0402X"]
[null,null,null,null,null,null,null,null,null,null,null,"2085N0700X"]
[null,null,null,null,null,null,null,null,null,null,null,"2084A2900X"]
[null,null,null,null,null,null,null,null,null,null,null,"207T00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"235Z00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207V00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VB0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VC0200X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VF0040X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VX0201X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VG0400X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VM0101X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VX0000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VE0102X"]
[null,null,null,null,null,null,null,null,null,null,null,"2086H0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207QH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207LH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207RH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207VH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"2084H0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207PH0002X"]
[null,null,null,null,null,null,null,null,null,null,null,"207W00000X"]
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[null,null,null,null,null,null,null,null,null,null,null,"207WX0107X"]
[null,null,null,null,null,null,null,null,null,null,null,"207WX0108X"]
[null,null,null,null,null,null,null,null,null,null,null,"207WX0109X"]
[null,null,null,null,null,null,null,null,null,null,null,"207WX0110X"]
[null,null,null,null,null,null,null,null,null,null,null,"207WX0120X"]
[null,null,null,null,null,null,null,null,null,null,null,"207WX0200X"]
[null,null,null,null,null,null,null,null,null,null,null,"1223S0112X"]
[null,null,null,null,null,null,null,null,null,null,null,"207X00000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0114X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0004X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0106X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XS0117X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0801X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XP3100X"]
[null,null,null,null,null,null,null,null,null,null,null,"207XX0005X"]
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[null,null,null,null,null,null,null,null,null,null,null,"207ZP0102X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZB0001X"]
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[null,null,null,null,null,null,null,null,null,null,null,"207ZC0006X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZP0105X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZC0500X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZD0900X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZF0201X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZH0000X"]
[null,null,null,null,null,null,null,null,null,null,null,"207ZI0100X"]
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[null,null,null,null,null,null,null,null,null,null,null,"207PS0010X"]
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[null,null,null,null,null,null,null,null,null,null,null,"2083S0010X"]
[null,null,null,null,null,null,null,null,null,null,null,"2084S0010X"]
[null,null,null,null,null,null,null,null,null,null,null,"208200000X"]
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[null,null,null,null,null,null,null,null,null,null,null,"2082S0105X"]
[null,null,null,null,null,null,null,null,null,null,null,"208100000X"]
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[null,null,null,null,null,null,null,null,null,null,null,"2084P0301X"]
[null,null,null,null,null,null,null,null,null,null,null,"207QG0300X"]
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[]
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["MEDICARE SPECIALTY CODE","MEDICARE PROVIDER/SUPPLIER TYPE DESCRIPTION","PROVIDER TAXONOMY CODE","PROVIDER TAXONOMY DESCRIPTION"]
[2,"Physician/General Surgery","2086H0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine"]
[2,"Physician/General Surgery","2086S0120X","Allopathic & Osteopathic Physicians/Surgery/Pediatric Surgery"]
[2,"Physician/General Surgery","2086S0122X","Allopathic & Osteopathic Physicians/Surgery/Plastic and Reconstructive Surgery"]
[2,"Physician/General Surgery","2086S0105X","Allopathic & Osteopathic Physicians/Surgery/Surgery of the Hand"]
[2,"Physician/General Surgery","2086S0102X","Allopathic & Osteopathic Physicians/Surgery/Surgical Critical Care"]
[2,"Physician/General Surgery","2086X0206X","Allopathic & Osteopathic Physicians/Surgery/Surgical Oncology"]
[2,"Physician/General Surgery","2086S0127X","Allopathic & Osteopathic Physicians/Surgery/Trauma Surgery"]
[2,"Physician/General Surgery","2086S0129X","Allopathic & Osteopathic Physicians/Surgery/Vascular Surgery"]
[2,"Physician/General Surgery","208G00000X","Allopathic & Osteopathic Physicians/Thoracic Surgery (Cardiothoracic Vascular Surgery)"]
[2,"Physician/General Surgery","204F00000X","Allopathic & Osteopathic Physicians/Transplant Surgery"]
[2,"Physician/General Surgery","208C00000X","Allopathic & Osteopathic Physicians/Colon & Rectal Surgery"]
[2,"Physician/General Surgery","207T00000X","Allopathic & Osteopathic Physicians/Neurological Surgery"]
[2,"Physician/General Surgery","204E00000X","Allopathic & Osteopathic Physicians/Oral & Maxillofacial Surgery"]
[2,"Physician/General Surgery","207X00000X","Allopathic & Osteopathic Physicians/Orthopedic Surgery"]
[2,"Physician/General Surgery","207XS0114X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Adult Reconstructive Orthopedic Surgery"]
[2,"Physician/General Surgery","207XX0004X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Foot and Ankle Surgery"]
[2,"Physician/General Surgery","207XS0106X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Hand Surgery"]
[2,"Physician/General Surgery","207XS0117X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Orthopedic Surgery of the Spine"]
[2,"Physician/General Surgery","207XX0801X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Orthopedic Trauma"]
[2,"Physician/General Surgery","207XP3100X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Pediatric Orthopedic Surgery"]
[2,"Physician/General Surgery","207XX0005X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Sports Medicine"]
[2,"Physician/General Surgery","208200000X","Allopathic & Osteopathic Physicians/Plastic Surgery"]
[2,"Physician/General Surgery","2082S0099X","Allopathic & Osteopathic Physicians/Plastic Surgery/Plastic Surgery Within the Head & Neck"]
[2,"Physician/General Surgery","2082S0105X","Allopathic & Osteopathic Physicians/Plastic Surgery/Surgery of the Hand"]
[3,"Physician/Allergy/ Immunology","207K00000X","Allopathic & Osteopathic Physicians/Allergy and Immunology"]
[3,"Physician/Allergy/ Immunology","207KA0200X","Allopathic & Osteopathic Physicians/Allergy and Immunology/Allergy"]
[3,"Physician/Allergy/ Immunology","207KI0005X","Allopathic & Osteopathic Physicians/Allergy and Immunology/Clinical & Laboratory Immunology"]
[4,"Physician/Otolaryngology","207Y00000X","Allopathic & Osteopathic Physicians/ Otolaryngology"]
[4,"Physician/Otolaryngology","207YS0123X","Allopathic & Osteopathic Physicians/ Otolaryngology/Facial Plastic Surgery"]
[4,"Physician/Otolaryngology","207YX0602X","Allopathic & Osteopathic Physicians/Otolaryngology/Otolaryngic Allergy"]
[4,"Physician/Otolaryngology","207YX0905X","Allopathic & Osteopathic Physicians/Otolaryngology/Otolaryngology/Facial Plastic Surgery"]
[4,"Physician/Otolaryngology","207YX0901X","Allopathic & Osteopathic Physicians/Otolaryngology/Otology &Neurotology"]
[4,"Physician/Otolaryngology","207YP0228X","Allopathic & Osteopathic Physicians/Otolaryngology/Pediatric Otolaryngology"]
[4,"Physician/Otolaryngology","207YX0007X","Allopathic & Osteopathic Physicians/Otolaryngology/Plastic Surgery within the Head & Neck"]
[4,"Physician/Otolaryngology","207YS0012X","Allopathic & Osteopathic Physicians/Otolaryngology/Sleep Medicine"]
[5,"Physician/Anesthesiology","207L00000X","Allopathic & Osteopathic Physicians/Anesthesiology"]
[5,"Physician/Anesthesiology","207LA0401X","Allopathic & Osteopathic Physicians/Anesthesiology/Addiction Medicine"]
[5,"Physician/Anesthesiology","207LC0200X","Allopathic & Osteopathic Physicians/Anesthesiology/Critical Care Medicine"]
[5,"Physician/Anesthesiology","207LH0002X","Allopathic & Osteopathic Physicians/Anesthesiology/Hospice and Palliative Medicine"]
[5,"Physician/Anesthesiology","207LP2900X","Allopathic & Osteopathic Physicians/Anesthesiology/Pain Medicine"]
[5,"Physician/Anesthesiology","207LP3000X","Allopathic & Osteopathic Physicians/Anesthesiology/Pediatric Anesthesiology"]
[6,"Physician/Cardiovascular Disease (Cardiology)","207RC0000X","Allopathic & Osteopathic Physicians/Internal Medicine, Cardiovascular Disease"]
[7,"Physician/Dermatology","207N00000X","Allopathic & Osteopathic Physicians/Dermatology"]
[7,"Physician/Dermatology","207NI0002X","Allopathic & Osteopathic Physicians/Dermatology, Clinical & Laboratory Dermatological Immunology"]
[7,"Physician/Dermatology","207ND0101X","Allopathic & Osteopathic Physicians/Dermatology, MOHS-Micrographic Surgery"]
[7,"Physician/Dermatology","207ND0900X","Allopathic & Osteopathic Physicians/Dermatology, Dermapathology"]
[7,"Physician/Dermatology","207NP0225X","Allopathic & Osteopathic Physicians/Dermatology, Pediatric Dermatology"]
[7,"Physician/Dermatology","207NS0135X","Allopathic &Osteopathic Physicians/Dermatology, Procedural Dermatology"]
[8,"Physician/Family Practice","207Q00000X","Allopathic & Osteopathic Physicians/Family Medicine"]
[8,"Physician/Family Practice","207QA0401X","Allopathic & Osteopathic Physicians/Family Medicine, Addiction Medicine"]
[8,"Physician/Family Practice","207QA0000X","Allopathic & Osteopathic Physicians/Family Medicine, Adolescent Medicine"]
[8,"Physician/Family Practice","207QA0505X","Allopathic & Osteopathic Physicians/Family Medicine, Adult Medicine"]
[8,"Physician/Family Practice","207QB0002X","Allopathic & Osteopathic Physicians/Family Medicine, Bariatric Medicine"]
[8,"Physician/Family Practice","207QG0300X","Allopathic & Osteopathic Physicians/Family Medicine, Geriatric Medicine"]
[8,"Physician/Family Practice","207QH0002X","Allopathic & Osteopathic Physicians/Family Medicine, Hospice and Palliative Medicine"]
[8,"Physician/Family Practice","207QS0010X","Allopathic & Osteopathic Physicians/Family Medicine, Sports Medicine"]
[8,"Physician/Family Practice","207QS1201X","Allopathic & Osteopathic Physicians/Family Medicine, Sleep Medicine"]
[9,"Physician/Interventional Pain Management","208VP0014X","Allopathic & Osteopathic Physicians/Pain Medicine, Interventional Pain Medicine"]
[10,"Physician/Gastroenterology","207RG0100X","Allopathic & Osteopathic Physicians/Internal Medicine, Gastroenterology"]
[11,"Physician/Internal Medicine","207R00000X","Allopathic & Osteopathic Physicians/Internal Medicine"]
[11,"Physician/Internal Medicine","207RA0401X","Allopathic & Osteopathic Physicians/Internal Medicine, Addiction Medicine"]
[11,"Physician/Internal Medicine","207RA0000X","Allopathic & Osteopathic Physicians/Internal Medicine, Adolescent Medicine"]
[11,"Physician/Internal Medicine","207RA0001X","Allopathic & Osteopathic Physicians/Advanced Heart Failure and Transplant Cardiology"]
[11,"Physician/Internal Medicine","207RA0201X","Allopathic & Osteopathic Physicians/Internal Medicine, Allergy & Immunology"]
[11,"Physician/Internal Medicine","207RB0002X","Allopathic & Osteopathic Physicians/Internal Medicine, Bariatric Medicine"]
[11,"Physician/Internal Medicine","207RC0000X","Allopathic & Osteopathic Physicians/Internal Medicine, Cardiovascular Disease"]
[11,"Physician/Internal Medicine","207RI0001X","Allopathic & Osteopathic Physicians/Internal Medicine, Clinical & Laboratory Immunology"]
[11,"Physician/Internal Medicine","207RC0200X","Allopathic & Osteopathic Physicians/Internal Medicine, Critical Care Medicine"]
[11,"Physician/Internal Medicine","207RE0101X","Allopathic & Osteopathic Physicians/Internal Medicine, Endocrinology, Diabetes, & Metabolism"]
[11,"Physician/Internal Medicine","207RG0100X","Allopathic & Osteopathic Physicians/Internal Medicine, Gastroenterology"]
[11,"Physician/Internal Medicine","207RG0300X","Allopathic & Osteopathic Physicians/Internal Medicine, Geriatric Medicine"]
[11,"Physician/Internal Medicine","207RH0000X","Allopathic & Osteopathic Physicians/Internal Medicine, Hematology"]
[11,"Physician/Internal Medicine","207RH0003X","Allopathic & Osteopathic Physicians/Internal Medicine, Hematology & Oncology"]
[11,"Physician/Internal Medicine","207RI0008X","Allopathic & Osteopathic Physicians/Internal Medicine, Hepatology"]
[11,"Physician/Internal Medicine","207RH0002X","Allopathic & Osteopathic Physicians/Internal Medicine, Hospice and Palliative Medicine"]
[11,"Physician/Internal Medicine","207RI0200X","Allopathic & Osteopathic Physicians/Internal Medicine, Infectious Disease"]
[11,"Physician/Internal Medicine","207RM1200X","Allopathic & Osteopathic Physicians/Internal Medicine, Magnetic Resonance Imaging (MRI)"]
[11,"Physician/Internal Medicine","207RX0202X","Allopathic & Osteopathic Physicians/Internal Medicine, Medical Oncology"]
[11,"Physician/Internal Medicine","207RN0300X","Allopathic & Osteopathic Physicians/Internal Medicine, Nephrology"]
[11,"Physician/Internal Medicine","207RP1001X","Allopathic & Osteopathic Physicians/Internal Medicine, Pulmonary Disease"]
[11,"Physician/Internal Medicine","207RR0500X","Allopathic & Osteopathic Physicians/Internal Medicine, Rheumatology"]
[11,"Physician/Internal Medicine","207RS0012X","Allopathic & Osteopathic Physicians/Internal Medicine, Sleep Medicine"]
[11,"Physician/Internal Medicine","207RS0010X","Allopathic & Osteopathic Physicians/Internal Medicine, Sports Medicine"]
[11,"Physician/Internal Medicine","207RT0003X","Allopathic & Osteopathic Physicians/Internal Medicine, Transplant Hepatology"]
[12,"Physician/Osteopathic Manipulative Medicine","204D00000X","Allopathic & Osteopathic Physicians/Neuromusculoskeletal Medicine & OMM"]
[12,"Physician/Osteopathic Manipulative Medicine","204C00000X","Allopathic & Osteopathic Physicians/Neuromusculoskeletal Medicine, Sports Medicine"]
[13,"Physician/Neurology","2084N0400X","Allopathic & Osteopathic Physicians/Psychiatry and Neurology, Neurology"]
[13,"Physician/Neurology","2084N0402X","Allopathic & Osteopathic Physicians/Psychiatry and Neurology, Neurology with Special Qualifications in Child Neurology"]
[13,"Physician/Neurology","2084A2900X","Allopathic & Osteopathic Physicians/Psychiatry & Neurology/Neurocritical Care"]
[14,"Physician/Neurosurgery","207T00000X","Allopathic & Osteopathic Physicians/Neurological Surgery"]
[15,"Speech Language Pathologist","235Z00000X","Speech, Language and Hearing Service Providers"]
[16,"Physician/Obstetrics & Gynecology","207V00000X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology"]
[16,"Physician/Obstetrics & Gynecology","207VB0002X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Bariatric Medicine"]
[16,"Physician/Obstetrics & Gynecology","207VC0200X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Critical Care Medicine"]
[16,"Physician/Obstetrics & Gynecology","207VF0040X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Female Pelvic Medicine and Reconstructive Surgery"]
[16,"Physician/Obstetrics & Gynecology","207VX0201X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Gynecologic Oncology"]
[16,"Physician/Obstetrics & Gynecology","207VG0400X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Gynecology"]
[16,"Physician/Obstetrics & Gynecology","207VH0002X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Hospice and Palliative Medicine"]
[16,"Physician/Obstetrics & Gynecology","207VM0101X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Maternal & Fetal Medicine"]
[16,"Physician/Obstetrics & Gynecology","207VX0000X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Obstetrics"]
[16,"Physician/Obstetrics & Gynecology","207VE0102X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Reproductive Endocrinology"]
[17,"Physician/Hospice and Palliative Care","2086H0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, General Surgery"]
[17,"Physician/Hospice and Palliative Care","207QH0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Family Practice"]
[17,"Physician/Hospice and Palliative Care","207LH0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Anesthesiology"]
[17,"Physician/Hospice and Palliative Care","207RH0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Internal Medicine"]
[17,"Physician/Hospice and Palliative Care","207VH0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Obstetrics & Gynecology"]
[17,"Physician/Hospice and Palliative Care","2084H0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Neuropsychiatry"]
[17,"Physician/Hospice and Palliative Care","207PH0002X","Allopathic & Osteopathic Physicians/Surgery/Hospice and Palliative Medicine, Emergency Medicine"]
[18,"Physician/Ophthalmology","207W00000X","Allopathic & Osteopathic Physicians/Ophthalmology"]
[18,"Physician/Ophthalmology","207WX0009X","Allopathic & Osteopathic Physicians/Ophthalmology, Glaucoma Specialist"]
[18,"Physician/Ophthalmology","207WX0107X","Allopathic & Osteopathic Physicians/Ophthalmology, Retina Specialist"]
[18,"Physician/Ophthalmology","207WX0108X","Allopathic & Osteopathic Physicians/Ophthalmology, Uveitis and Ocular Inflammatory Disease"]
[18,"Physician/Ophthalmology","207WX0109X","Allopathic & Osteopathic Physicians/Ophthalmology/Neuro-ophthalmology"]
[18,"Physician/Ophthalmology","207WX0110X","Allopathic & Osteopathic Physicians/Ophthalmology/Pediatric Ophthalmology and Strabismus Specialist"]
[18,"Physician/Ophthalmology","207WX0120X","Allopathic & Osteopathic Physicians/Ophthalmology, Cornea and External Diseases Specialist"]
[18,"Physician/Ophthalmology","207WX0200X","Allopathic & Osteopathic Physicians/Ophthalmic Plastic and Reconstructive Surgery"]
[19,"Oral Surgery (Dentist only)","1223S0112X","Allopathic & Osteopathic Physicians/Ophthalmology, Dental Providers/Dentist, Oral & Maxillofacial Surgery"]
[20,"Physician/Orthopedic Surgery","207X00000X","Allopathic & Osteopathic Physicians/Orthopedic Surgery"]
[20,"Physician/Orthopedic Surgery","207XS0114X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Adult Reconstructive Orthopedic Surgery"]
[20,"Physician/Orthopedic Surgery","207XX0004X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Foot and Ankle Surgery"]
[20,"Physician/Orthopedic Surgery","207XS0106X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Hand Surgery"]
[20,"Physician/Orthopedic Surgery","207XS0117X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Orthopedic Surgery of the Spine"]
[20,"Physician/Orthopedic Surgery","207XX0801X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Orthopedic Trauma"]
[20,"Physician/Orthopedic Surgery","207XP3100X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Pediatric Orthopedic Surgery"]
[20,"Physician/Orthopedic Surgery","207XX0005X","Allopathic & Osteopathic Physicians/Orthopedic Surgery, Sports Medicine"]
[21,"Clinical Cardiac Electrophysiology","207RC0001X","Allopathic & Osteopathic Physicians/Internal Medicine, Clinical Cardiatric Electrophysiology"]
[22,"Physician/Pathology","207ZP0101X","Allopathic & Osteopathic Physicians/Pathology, Anatomic Pathology"]
[22,"Physician/Pathology","207ZP0102X","Allopathic & Osteopathic Physicians/Pathology, Anatomic Pathology & Clinical Pathology"]
[22,"Physician/Pathology","207ZB0001X","Allopathic & Osteopathic Physicians/Pathology, Blood Banking & Transfusion Medicine"]
[22,"Physician/Pathology","207ZP0104X","Allopathic & Osteopathic Physicians/Pathology, Chemical Pathology"]
[22,"Physician/Pathology","207ZC0006X","Allopathic & Osteopathic Physicians/Pathology, Clinical Pathology"]
[22,"Physician/Pathology","207ZP0105X","Allopathic & Osteopathic Physicians/Pathology, Clinical Pathology/Laboratory Medicine"]
[22,"Physician/Pathology","207ZC0500X","Allopathic & Osteopathic Physicians/Pathology, Cytopathology"]
[22,"Physician/Pathology","207ZD0900X","Allopathic & Osteopathic Physicians/Pathology, Dermapathology"]
[22,"Physician/Pathology","207ZF0201X","Allopathic & Osteopathic Physicians/Pathology, Forensic Pathology"]
[22,"Physician/Pathology","207ZH0000X","Allopathic & Osteopathic Physicians/Pathology, Hematology"]
[22,"Physician/Pathology","207ZI0100X","Allopathic & Osteopathic Physicians/Pathology, Immunopathology"]
[22,"Physician/Pathology","207ZM0300X","Allopathic & Osteopathic Physicians/Pathology, Medical Microbiology"]
[22,"Physician/Pathology","207ZP0007X","Allopathic & Osteopathic Physicians/Pathology, Molecular Genetic Pathology"]
[22,"Physician/Pathology","207ZN0500X","Allopathic & Osteopathic Physicians/Pathology, Neuropathology"]
[22,"Physician/Pathology","207ZP0213X","Allopathic & Osteopathic Physicians/Pathology, Pediatric Pathology"]
[23,"Physician/Sports Medicine","207XX0005X","Allopathic & Osteopathic Physicians/Orthopedic Surgery/Sports Medicine"]
[23,"Physician/Sports Medicine","207PS0010X","Allopathic & Osteopathic Physicians/Emergency Medicine, Sports Medicine"]
[23,"Physician/Sports Medicine","207QS0010X","Allopathic & Osteopathic Physicians/Family Medicine, Sports Medicine"]
[23,"Physician/Sports Medicine","207RS0010X","Allopathic & Osteopathic Physicians/Internal Medicine, Sports Medicine"]
[23,"Physician/Sports Medicine","204C00000X","Allopathic & Osteopathic Physicians/Neuromusculoskeletal Medicine, Sports Medicine"]
[23,"Physician/Sports Medicine","2080S0010X","Allopathic & Osteopathic Physicians/Pediatrics, Sports Medicine"]
[23,"Physician/Sports Medicine","2081P0301X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Brain Injury"]
[23,"Physician/Sports Medicine","2081S0010X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Sports Medicine"]
[23,"Physician/Sports Medicine","2083S0010X","Allopathic & Osteopathic Physicians/Preventive Medicine, Sports Medicine"]
[23,"Physician/Sports Medicine","2084S0010X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Sports Medicine"]
[24,"Physician/Plastic and Reconstructive Surgery","208200000X","Allopathic & Osteopathic Physicians/Plastic Surgery"]
[24,"Physician/Plastic and Reconstructive Surgery","2082S0099X","Allopathic & Osteopathic Physicians/Plastic Surgery, Plastic Surgery Within the Head and Neck"]
[24,"Physician/Plastic and Reconstructive Surgery","2082S0105X","Allopathic & Osteopathic Physicians/Plastic Surgery, Surgery of the Hand"]
[25,"Physician/Physical Medicine and Rehabilitation","208100000X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation"]
[25,"Physician/Physical Medicine and Rehabilitation","2081H0002X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Hospice and Palliative Medicine"]
[25,"Physician/Physical Medicine and Rehabilitation","2081N0008X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Neuromuscular Medicine"]
[25,"Physician/Physical Medicine and Rehabilitation","2081P2900X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Pain Medicine"]
[25,"Physician/Physical Medicine and Rehabilitation","2081P0010X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine"]
[25,"Physician/Physical Medicine and Rehabilitation","2081P0004X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine"]
[25,"Physician/Physical Medicine and Rehabilitation","2081S0010X","Allopathic & Osteopathic Physicians/Physical Medicine & Rehabilitation, Sports Medicine"]
[26,"Physician/Psychiatry","2084P0800X","Allopathic & Osteopathic Physicians/Psychiatry"]
[26,"Physician/Psychiatry","2084P0301X","Allopathic & Osteopathic Physicians/Psychiatry & Neurology/Respiratory, Developmental, Rehabilitative and Restorative Service , Brain Injury Medicine"]
[27,"Physician/Geriatric Psychiatry","207QG0300X","Allopathic & Osteopathic Physicians/Family Medicine, Geriatric Medicine"]
[28,"Physician/Colorectal Surgery (Proctology)","208C00000X","Allopathic & Osteopathic Physicians/Colon & Rectal Surgery"]
[29,"Physician/Pulmonary Disease","207RP1001X","Allopathic & Osteopathic Physicians/Internal Medicine, Pulmonary Disease"]
[30,"Physician/Diagnostic Radiology","2085R0202X","Allopathic & Osteopathic Physicians/Radiology, Diagnostic Radiology"]
[31,"Intensive Cardiac Rehabilitation","163WC3500X","Nursing Service Providers, Registered Nurse, Cardiac Rehabilitation"]
[32,"Anesthesiology Assistant","367H00000X","Physician Assistants & Advanced Practice Nursing Providers/Anesthesiologist Assistant"]
[33,"Physician/Thoracic Surgery","208G00000X","Allopathic & Osteopathic Physicians/Thoracic Surgery (Cardiothoracic Vascular Surgery)"]
[34,"Physician/Urology","208800000X","Allopathic & Osteopathic Physicians/Urology"]
[34,"Physician/Urology","2088P0231X","Allopathic & Osteopathic Physicians/Urology, Pediatric Urology"]
[34,"Physician/Urology","2088F0040X","Female Pelvic Medicine & Reconstructive Surgery"]
[35,"Chiropractic","111N00000X","Chiropractic Providers/Chiropractor"]
[35,"Chiropractic","111NI0013X","Chiropractic Providers/Chiropractor, Independent Medical Examiner"]
[35,"Chiropractic","111NI0900X","Chiropractic Providers/Chiropractor, Internist"]
[35,"Chiropractic","111NN0400X","Chiropractic Providers/Chiropractor, Neurology"]
[35,"Chiropractic","111NN1001X","Chiropractic Providers/Chiropractor, Nutrition"]
[35,"Chiropractic","111NX0100X","Chiropractic Providers/Chiropractor, Occupational Medicine"]
[35,"Chiropractic","111NX0800X","Chiropractic Providers/Chiropractor, Orthopedic"]
[35,"Chiropractic","111NP0017X","Chiropractic Providers/Chiropractor, Pediatric Chiropractor"]
[35,"Chiropractic","111NR0200X","Chiropractic Providers/Chiropractor, Radiology"]
[35,"Chiropractic","111NR0400X","Chiropractic Providers/Chiropractor, Rehabilitation"]
[35,"Chiropractic","111NS0005X","Chiropractic Providers/Chiropractor, Sports Physician"]
[35,"Chiropractic","111NT0100X","Chiropractic Providers/Chiropractor, Thermography"]
[36,"Physician/Nuclear Medicine","207U00000X","Allopathic & Osteopathic Physicians/Nuclear Medicine"]
[36,"Physician/Nuclear Medicine","207UN0903X","Allopathic & Osteopathic Physicians/Nuclear Medicine, In Vivo & In Vitro Nuclear Medicine"]
[36,"Physician/Nuclear Medicine","207UN0901X","Allopathic & Osteopathic Physicians/Nuclear Medicine, Nuclear Cardiology"]
[36,"Physician/Nuclear Medicine","207UN0902X","Allopathic & Osteopathic Physicians/Nuclear Medicine, Nuclear Imaging & Therapy"]
[37,"Physician/Pediatric Medicine","208000000X","Allopathic & Osteopathic Physicians/Pediatrics"]
[37,"Physician/Pediatric Medicine","2080A0000X","Allopathic & Osteopathic Physicians/Pediatrics, Adolescent Medicine"]
[37,"Physician/Pediatric Medicine","2080I0007X","Allopathic & Osteopathic Physicians/Pediatrics, Clinical & Laboratory Immunology"]
[37,"Physician/Pediatric Medicine","2080P0006X","Allopathic & Osteopathic Physicians/Pediatrics, Developmental–Behavioral Pediatrics"]
[37,"Physician/Pediatric Medicine","2080H0002X","Allopathic & Osteopathic Physicians/Pediatrics, Hospice and Palliative Medicine"]
[37,"Physician/Pediatric Medicine","2080T0002X","Allopathic & Osteopathic Physicians/Pediatrics, Medical Toxicology"]
[37,"Physician/Pediatric Medicine","2080N0001X","Allopathic & Osteopathic Physicians/Pediatrics, Neonatal-Perinatal Medicine"]
[37,"Physician/Pediatric Medicine","2080P0008X","Allopathic & Osteopathic Physicians/Pediatrics, Neurodevelopmental Disabilities"]
[37,"Physician/Pediatric Medicine","2080P0201X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Allergy & Immunology"]
[37,"Physician/Pediatric Medicine","2080P0202X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Cardiology"]
[37,"Physician/Pediatric Medicine","2080P0203X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Critical Care Medicine"]
[37,"Physician/Pediatric Medicine","2080P0204X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Emergency Medicine"]
[37,"Physician/Pediatric Medicine","2080P0205X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Endocrinology"]
[37,"Physician/Pediatric Medicine","2080P0206X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Gastroenterology"]
[37,"Physician/Pediatric Medicine","2080P0207X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Hematology-Oncology"]
[37,"Physician/Pediatric Medicine","2080P0208X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Infectious Diseases"]
[37,"Physician/Pediatric Medicine","2080P0210X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Nephrology"]
[37,"Physician/Pediatric Medicine","2080P0214X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Pulmonology"]
[37,"Physician/Pediatric Medicine","2080P0216X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Rheumatology"]
[37,"Physician/Pediatric Medicine","2080T0004X","Allopathic & Osteopathic Physicians/Pediatrics, Pediatric Transplant Hepatology"]
[37,"Physician/Pediatric Medicine","2080S0012X","Allopathic & Osteopathic Physicians/Pediatrics, Sleep Medicine"]
[37,"Physician/Pediatric Medicine","2080S0010X","Allopathic & Osteopathic Physicians/Pediatrics, Sports Medicine"]
[38,"Physician/Geriatric Medicine","207RG0300X","Allopathic & Osteopathic Physicians/Internal Medicine, Geriatric Medicine"]
[38,"Physician/Geriatric Medicine","207QG0300X","Allopathic & Osteopathic Physicians/Family Medicine, Geriatric Medicine"]
[39,"Physician/Nephrology","207RN0300X","Allopathic & Osteopathic Physicians/Internal Medicine, Nephrology"]
[40,"Physician/Hand Surgery","2086S0105X","Allopathic & Osteopathic Physicians/Surgery, Surgery of the Hand"]
[40,"Physician/Hand Surgery","2082S0105X","Allopathic & Osteopathic Physicians/Plastic Surgery, Surgery of the Hand"]
[41,"Optometry","152W00000X","Eye and Vision Service Providers/Optometrist"]
[41,"Optometry","152WC0802X","Eye and Vision Service Providers/Optometrist, Corneal and Contact Management"]
[41,"Optometry","152WL0500X","Eye and Vision Service Providers/Optometrist, Low Vision Rehabilitation"]
[41,"Optometry","152WX0102X","Eye and Vision Service Providers/Optometrist, Occupational Vision"]
[41,"Optometry","152WP0200X","Eye and Vision Service Providers/Optometrist, Pediatrics"]
[41,"Optometry","152WS0006X","Eye and Vision Service Providers/Optometrist, Sports Vision"]
[41,"Optometry","152WV0400X","Eye and Vision Service Providers/Optometrist, Vision Therapy"]
[42,"Certified Nurse Midwife","367A00000X","Physician Assistants & Advanced Practice Nursing Providers/Midwife, Certified Nurse"]
[43,"Certified Registered Nurse Anesthetist (CRNA)","367500000X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Anesthetist, Certified Registered"]
[44,"Physician/Infectious Disease","207RI0200X","Allopathic & Osteopathic Physicians/Internal Medicine, Infectious Disease"]
[45,"Mammography Center","261QR0208X","Ambulatory Health Care Facilities/Clinic-Center, Radiology, Mammography"]
[45,"Mammography Center","261QR0207X","Ambulatory Health Care Facilities/Clinic-Center, Radiology, Mobile Mammography"]
[46,"Physician/Endocrinology","207RE0101X","Allopathic & Osteopathic Physicians/Internal Medicine, Endocrinology, Diabetes & Metabolism"]
[47,"Independent Diagnostic Testing Facility (IDTF)","293D00000X","Laboratories/Physiological Laboratory"]
[48,"Podiatry","213E00000X","Podiatric Medicine & Surgery Service Providers/Podiatrist"]
[48,"Podiatry","213ES0103X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Foot & Ankle Surgery"]
[48,"Podiatry","213ES0131X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Foot Surgery"]
[48,"Podiatry","213EG0000X","Podiatric Medicine & Surgery Service Providers/Podiatrist, General Practice"]
[48,"Podiatry","213EP1101X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Primary Podiatric Medicine"]
[48,"Podiatry","213EP0504X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Public Medicine"]
[48,"Podiatry","213ER0200X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Radiology"]
[48,"Podiatry","213ES0000X","Podiatric Medicine & Surgery Service Providers/Podiatrist, Sports Medicine"]
[49,"Ambulatory Surgical Center","261QA1903X","Ambulatory Health Care Facilities/Clinic-Center, Ambulatory Surgical"]
[50,"Nurse Practitioner","363L00000X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner"]
[50,"Nurse Practitioner","363LA2100X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Acute Care"]
[50,"Nurse Practitioner","363LA2200X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Adult Health"]
[50,"Nurse Practitioner","363LC1500X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Community Health"]
[50,"Nurse Practitioner","363LC0200X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Critical Care Medicine"]
[50,"Nurse Practitioner","363LF0000X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Family"]
[50,"Nurse Practitioner","363LG0600X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Gerontology"]
[50,"Nurse Practitioner","363LN0000X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Neonatal"]
[50,"Nurse Practitioner","363LN0005X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Neonatal, Critical Care"]
[50,"Nurse Practitioner","363LX0001X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Obstetrics & Gynecology"]
[50,"Nurse Practitioner","363LX0106X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Occupational Health"]
[50,"Nurse Practitioner","363LP0200X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Pediatrics"]
[50,"Nurse Practitioner","363LP0222X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Pediatrics, Critical Care"]
[50,"Nurse Practitioner","363LP1700X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Perinatal"]
[50,"Nurse Practitioner","363LP2300X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Primary Care"]
[50,"Nurse Practitioner","363LP0808X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Psychiatric/Mental Health"]
[50,"Nurse Practitioner","363LS0200X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, School"]
[50,"Nurse Practitioner","363LW0102X","Physician Assistants & Advanced Practice Nursing Providers/Nurse Practitioner, Women’s Health"]
[51,"Medical Supply Company with Orthotist","335E00000X","Suppliers/Prosthetic/Orthotic Supplier"]
[52,"Medical Supply Company with Prosthetist","335E00000X","Suppliers/Prosthetic/Orthotic Supplier"]
[53,"Medical Supply Company with Orthotist-Prosthetist","335E00000X","Suppliers/Prosthetic/Orthotic Supplier"]
[54,"Other Medical Supply Company","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
[55,"Individual Certified Orthotist","222Z00000X","Respiratory, Developmental, Rehabilitative, and Restorative Service Providers/Orthotist"]
[56,"Individual Certified Prosthetist","224P00000X\n229N00000X","Respiratory, Developmental, Rehabilitative, and Restorative Service Providers/Prosthetist\nRespiratory, Developmental, Rehabilitative, and Restorative Service Providers/Anaplastologist"]
[56,"Individual Certified Prosthetist"]
[57,"Individual Certified Prosthetist-Orthotist","222Z00000X","Respiratory, Developmental, Rehabilitative, and Restorative Service Providers/Orthotist"]
[57,"Individual Certified Prosthetist-Orthotist","229N00000X","Respiratory, Developmental, Rehabilitative, and Restorative Service Providers/Anaplastologist"]
[57,"Individual Certified Prosthetist-Orthotist","224P00000X","Respiratory, Developmental, Rehabilitative, and Restorative Service Providers/Prosthetist"]
[58,"Medical Supply Company with Pharmacist","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
[58,"Medical Supply Company with Pharmacist","333600000X","Suppliers/Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336C0002X","Suppliers/Pharmacy, Clinic Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336C0003X","Suppliers/Pharmacy, Community/Retail Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336C0004X","Suppliers/Pharmacy, Compounding Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336H0001X","Suppliers/Pharmacy, Home Infusion Therapy Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336I0012X","Suppliers/Pharmacy, Institutional Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336L0003X","Suppliers/Pharmacy, Long-term Care Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336M0002X","Suppliers/Pharmacy, Mail Order Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336M0003X","Suppliers/Pharmacy, Managed Care Organization Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336N0007X","Suppliers/Pharmacy, Nuclear Pharmacy"]
[58,"Medical Supply Company with Pharmacist","3336S0011X","Suppliers/Pharmacy, Specialty Pharmacy"]
[59,"Ambulance Service Provider","341600000X","Transportation Services/Ambulance"]
[59,"Ambulance Service Provider","3416A0800X","Transportation Services/Ambulance, Air Transport"]
[59,"Ambulance Service Provider","3416L0300X","Transportation Services/Ambulance, Land Transport"]
[59,"Ambulance Service Provider","3416S0300X","Transportation Services/Ambulance, Water Transport"]
[60,"Public Health or Welfare Agency","251K00000X","Agencies/Public Health or Welfare"]
[61,"Voluntary Health or Charitable Agency[1]","251V00000X","Agencies/Voluntary or Charitable"]
[62,"Psychologist, Clinical","103T00000X","Behavioral Health & Social Service Providers/Psychologist"]
[62,"Psychologist, Clinical","103TA0400X","Behavioral Health & Social Service Providers/Psychologist, Addiction (Substance Abuse Disorder)"]
[62,"Psychologist, Clinical","103TA0700X","Behavioral Health & Social Service Providers/Psychologist, Adult Development & Aging"]
[62,"Psychologist, Clinical","103TC0700X","Behavioral Health & Social Service Providers/Psychologist, Clinical"]
[62,"Psychologist, Clinical","103TC2200X","Behavioral Health & Social Service Providers/Psychologist, Clinical Child & Adolescent"]
[62,"Psychologist, Clinical","103TB0200X","Behavioral Health & Social Service Providers/Psychologist, Cognitive & Behavioral"]
[62,"Psychologist, Clinical","103TC1900X","Behavioral Health & Social Service Providers/Psychologist, Counseling"]
[62,"Psychologist, Clinical","103TE1000X","Behavioral Health & Social Service Providers/Psychologist, Educational"]
[62,"Psychologist, Clinical","103TE1100X","Behavioral Health & Social Service Providers/Psychologist, Exercise & Sports"]
[62,"Psychologist, Clinical","103TF0000X","Behavioral Health & Social Service Providers/Psychologist, Family"]
[62,"Psychologist, Clinical","103TF0200X","Behavioral Health & Social Service Providers/Psychologist, Forensic"]
[62,"Psychologist, Clinical","103TP2701X","Behavioral Health & Social Service Providers/Psychologist, Group Psychotherapy"]
[62,"Psychologist, Clinical","103TH0004X","Behavioral Health & Social Service Providers/Psychologist, Health"]
[62,"Psychologist, Clinical","103TH0100X","Behavioral Health & Social Service Providers/Psychologist, Health Service"]
[62,"Psychologist, Clinical","103TM1700X","Behavioral Health & Social Service Providers/Psychologist, Men & Masculinity"]
[62,"Psychologist, Clinical","103TM1800X","Behavioral Health & Social Service Providers/Psychologist, Mental Retardation & Developmental Disabilities"]
[62,"Psychologist, Clinical","103TP0016X","Behavioral Health & Social Service Providers/Psychologist, Prescribing (Medical)"]
[62,"Psychologist, Clinical","103TP0814X","Behavioral Health & Social Service Providers/Psychologist, Psychoanalysis"]
[62,"Psychologist, Clinical","103TP2700X","Behavioral Health & Social Service Providers/Psychologist, Psychotherapy"]
[62,"Psychologist, Clinical","103TR0400X","Behavioral Health & Social Service Providers/Psychologist, Rehabilitation"]
[62,"Psychologist, Clinical","103TS0200X","Behavioral Health & Social Service Providers/Psychologist, School"]
[62,"Psychologist, Clinical","103TW0100X","Behavioral Health & Social Service Providers/Psychologist, Women"]
[62,"Psychologist, Clinical","106E00000X","Behavioral Health & Social Service Providers/Assistant Behavior Analyst"]
[62,"Psychologist, Clinical","106S00000X","Behavioral Health & Social Service Providers/Technician"]
[63,"Portable X-Ray Supplier","335V00000X","Suppliers/Portable X-Ray Supplier"]
[64,"Audiologist","231H00000X","Speech, Language and Hearing Service Providers/Audiologist"]
[64,"Audiologist","231HA2400X","Speech, Language and Hearing Service Providers/Audiologist, Assistive Technology Practitioner"]
[65,"Physical Therapist in Private Practice","225100000X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist"]
[65,"Physical Therapist in Private Practice","2251C2600X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Cardiopulmonary"]
[65,"Physical Therapist in Private Practice","2251E1300X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Electrophysiology, Clinical"]
[65,"Physical Therapist in Private Practice","2251E1200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Ergonomics"]
[65,"Physical Therapist in Private Practice","2251G0304X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Geriatrics"]
[65,"Physical Therapist in Private Practice","2251H1200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Hand"]
[65,"Physical Therapist in Private Practice","2251H1300X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Human Factors"]
[65,"Physical Therapist in Private Practice","2251N0400X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Neurology"]
[65,"Physical Therapist in Private Practice","2251X0800X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Orthopedic"]
[65,"Physical Therapist in Private Practice","2251P0200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Physical Therapist, Pediatrics"]
[65,"Physical Therapist in Private Practice","2251S0007X","Respiratory, Rehabilitative & Restorative Service Providers/Physical Therapist, Sports"]
[66,"Physician/Rheumatology","207RR0500X","Allopathic & Osteopathic Physicians/Internal Medicine, Rheumatology"]
[67,"Occupational Therapist in Private Practice","225X00000X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist"]
[67,"Occupational Therapist in Private Practice","225XR0403X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Driving and Community Mobility"]
[67,"Occupational Therapist in Private Practice","225XE0001X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Environmental Modification"]
[67,"Occupational Therapist in Private Practice","225XE1200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Ergonomics"]
[67,"Occupational Therapist in Private Practice","225XF0002X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Feeding, Eating &Swallowing"]
[67,"Occupational Therapist in Private Practice","225XG0600X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Gerontology"]
[67,"Occupational Therapist in Private Practice","225XH1200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Hand"]
[67,"Occupational Therapist in Private Practice","225XH1300X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Human Factors"]
[67,"Occupational Therapist in Private Practice","225XL0004X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Low Vision"]
[67,"Occupational Therapist in Private Practice","225XM0800X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Mental Health"]
[67,"Occupational Therapist in Private Practice","225XN1300X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Neurorehabilitation"]
[67,"Occupational Therapist in Private Practice","225XP0200X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Pediatrics"]
[67,"Occupational Therapist in Private Practice","225XP0019X","Respiratory, Developmental, Rehabilitative & Restorative Service Providers/Occupational Therapist, Physical Rehabilitation"]
[68,"Psychologist, Clinical","103TC0700X","Behavioral Health & Social Service Providers/Psychologist, Clinical"]
[69,"Clinical Laboratory","291U00000X","Laboratories/Clinical Medical Laboratory"]
[70,"Clinic or Group Practice","261QM1300X","Ambulatory Health Care Facilities/Clinic/Center, Multi-Specialty"]
[70,"Clinic or Group Practice","261QP2000X","Ambulatory Health Care Facilities/Clinic/Center, Physical Therapy"]
[70,"Clinic or Group Practice","193200000X","Group/Multi-Specialty"]
[70,"Clinic or Group Practice","261Q00000X","Ambulatory Health Care Facilities/Clinic/Center, Multi-Specialty"]
[70,"Clinic or Group Practice","193400000X","Group/Single-Specialty"]
[71,"Registered Dietitian or Nutrition Professional","133V00000X","Dietary & Nutritional Service Providers/Dietician, Registered"]
[71,"Registered Dietitian or Nutrition Professional","133VN1006X","Dietary & Nutritional Service Providers/Dietician, Registered, Nutrition, Metabolic"]
[71,"Registered Dietitian or Nutrition Professional","133VN1004X","Dietary & Nutritional Service Providers/Dietician, Registered, Nutrition, Pediatric"]
[71,"Registered Dietitian or Nutrition Professional","133VN1005X","Dietary & Nutritional Service Providers/Dietician, Registered, Nutrition, Renal"]
[72,"Physician/Pain Management","208VP0000X","Allopathic & Osteopathic Physicians/Pain Medicine, Pain Medicine"]
[73,"Mass Immunizer Roster Biller[2]"]
[74,"Radiation Therapy Center","261QR0200X","Ambulatory Health Care Facilities/Clinic/Center, Radiology"]
[75,"Slide Preparation Facility","247200000X","Technologists, Technicians & Other Technical Service Providers/Technician, Other"]
[76,"Physician/Peripheral Vascular Disease","2086S0129X","Allopathic & Osteopathic Physicians/Surgery, Vascular Surgery"]
[77,"Physician/Vascular Surgery","2086S0129X","Allopathic & Osteopathic Physicians/Surgery, Vascular Surgery"]
[78,"Physician/Cardiac Surgery","208G00000X","Allopathic & Osteopathic Physicians/Thoracic Surgery (Cardiothoracic Vascular Surgery)"]
[79,"Physician/Addiction Medicine","207L00000X","Allopathic & Osteopathic Physicians/Anesthesiology, Addiction Medicine"]
[79,"Physician/Addiction Medicine","207QA0401X","Allopathic & Osteopathic Physicians/Family Medicine, Addiction Medicine"]
[79,"Physician/Addiction Medicine","207RA0401X","Allopathic & Osteopathic Physicians/Internal Medicine, Addiction Medicine"]
[79,"Physician/Addiction Medicine","2084A0401X","Allopathic & Osteopathic Physicians/Psychiatry & Neurology, Addiction Medicine"]
[80,"Licensed Clinical Social Worker","1041C0700X","Behavioral Health & Social Service Providers/Social Worker, Clinical"]
[81,"Physician/Critical Care (Intensivists)","207RC0200X","Allopathic & Osteopathic Physicians/Internal Medicine, Critical Care Medicine"]
[82,"Physician/Hematology","207RH0000X","Allopathic & Osteopathic Physicians/Internal Medicine, Hematology"]
[83,"Physician/Hematology-Oncology","207RH0003X","Allopathic & Osteopathic Physicians/Internal Medicine, Hematology & Oncology"]
[84,"Physician/Preventive Medicine","2083A0100X","Allopathic & Osteopathic Physicians/Preventive Medicine, Aerospace Medicine"]
[84,"Physician/Preventive Medicine","2083T0002X","Allopathic & Osteopathic Physicians/Preventive Medicine, Medical Toxicology"]
[84,"Physician/Preventive Medicine","2083X0100X","Allopathic & Osteopathic Physicians/Preventive Medicine, Occupational Medicine"]
[84,"Physician/Preventive Medicine","2083P0500X","Allopathic & Osteopathic Physicians/Preventive Medicine,  Preventive Medicine/Occupational Environmental Medicine"]
[84,"Physician/Preventive Medicine","2083P0901X","Allopathic & Osteopathic Physicians/Preventive Medicine, Public Health & General Preventive Medicine"]
[84,"Physician/Preventive Medicine","2083S0010X","Allopathic & Osteopathic Physicians/Preventive Medicine, Sports Medicine"]
[84,"Physician/Preventive Medicine","2083P0011X","Allopathic & Osteopathic Physicians/Preventive Medicine, Undersea and Hyperbaric Medicine"]
[85,"Physician/Maxillofacial Surgery","204E00000X","Allopathic & Osteopathic Physicians/Oral and Maxillofacial Surgery"]
[86,"Physician/Neuropsychiatry","2084A0401X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology"]
[86,"Physician/Neuropsychiatry","2084P0802X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Addiction Psychiatry"]
[86,"Physician/Neuropsychiatry","2084B0002X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Bariatric Medicine"]
[86,"Physician/Neuropsychiatry","2084P0804X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Child & Adolescent Psychiatry"]
[86,"Physician/Neuropsychiatry","2084N0600X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Clinical Neurophysiology"]
[86,"Physician/Neuropsychiatry","2084D0003X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Diagnostic Neuroimaging"]
[86,"Physician/Neuropsychiatry","2084F0202X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Forensic Psychiatry"]
[86,"Physician/Neuropsychiatry","2084P0805X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Geriatric Psychiatry"]
[86,"Physician/Neuropsychiatry","2084H0002X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Hospice & Palliative Medicine"]
[86,"Physician/Neuropsychiatry","2084P0005X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Neurodevelopmental Disabilities"]
[86,"Physician/Neuropsychiatry","2084N0400X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Neurology"]
[86,"Physician/Neuropsychiatry","2084N0402X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology"]
[86,"Physician/Neuropsychiatry","2084N0008X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Neuromuscular Medicine"]
[86,"Physician/Neuropsychiatry","2084P2900X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Pain Medicine"]
[86,"Physician/Neuropsychiatry","2084P0800X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Psychiatry"]
[86,"Physician/Neuropsychiatry","2084P0015X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Psychosomatic Medicine"]
[86,"Physician/Neuropsychiatry","2084S0012X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Sleep Medicine"]
[86,"Physician/Neuropsychiatry","2084S0010X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Sports Medicine"]
[86,"Physician/Neuropsychiatry","2084V0102X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Vascular Neurology"]
["87[3]","All Other Suppliers","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
[88,"Unknown Supplier/Provider Specialty[4]"]
[89,"Certified Clinical Nurse Specialist","364S00000X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist"]
[89,"Certified Clinical Nurse Specialist","364SA2100X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Acute Care"]
[89,"Certified Clinical Nurse Specialist","364SA2200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Adult Health"]
[89,"Certified Clinical Nurse Specialist","364SC2300X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Chronic Care"]
[89,"Certified Clinical Nurse Specialist","364SC1501X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Community Health/Public Health"]
[89,"Certified Clinical Nurse Specialist","364SC0200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Critical Care Medicine"]
[89,"Certified Clinical Nurse Specialist","364SE0003X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Emergency"]
[89,"Certified Clinical Nurse Specialist","364SE1400X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Ethics"]
[89,"Certified Clinical Nurse Specialist","364SF0001X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Family Health"]
[89,"Certified Clinical Nurse Specialist","364SG0600X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Gerontology"]
[89,"Certified Clinical Nurse Specialist","364SH1100X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Holistic"]
[89,"Certified Clinical Nurse Specialist","364SH0200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Home Health"]
[89,"Certified Clinical Nurse Specialist","364SI0800X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Informatics"]
[89,"Certified Clinical Nurse Specialist","364SL0600X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Long-term Care"]
[89,"Certified Clinical Nurse Specialist","364SM0705X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Medical-Surgical"]
[89,"Certified Clinical Nurse Specialist","364SN0000X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Neonatal"]
[89,"Certified Clinical Nurse Specialist","364SN0800X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Neuroscience"]
[89,"Certified Clinical Nurse Specialist","364SX0106X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Occupational Health"]
[89,"Certified Clinical Nurse Specialist","364SX0200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Oncology"]
[89,"Certified Clinical Nurse Specialist","364SX0204X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Oncology, Pediatrics"]
[89,"Certified Clinical Nurse Specialist","364SP0200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Pediatrics"]
[89,"Certified Clinical Nurse Specialist","364SP1700X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Perinatal"]
[89,"Certified Clinical Nurse Specialist","364SP2800X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Perioperative"]
[89,"Certified Clinical Nurse Specialist","364SP0808X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health"]
[89,"Certified Clinical Nurse Specialist","364SP0809X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Adult"]
[89,"Certified Clinical Nurse Specialist","364SP0807X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Adolescent"]
[89,"Certified Clinical Nurse Specialist","364SP0810X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family"]
[89,"Certified Clinical Nurse Specialist","364SP0811X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Chronically Ill"]
[89,"Certified Clinical Nurse Specialist","364SP0812X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Community"]
[89,"Certified Clinical Nurse Specialist","364SP0813X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Psychiatric/Mental Health, Geropsychiatric"]
[89,"Certified Clinical Nurse Specialist","364SR0400X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Rehabilitation"]
[89,"Certified Clinical Nurse Specialist","364SS0200X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, School"]
[89,"Certified Clinical Nurse Specialist","364ST0500X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Transplantation"]
[89,"Certified Clinical Nurse Specialist","364SW0102X","Physician Assistants & Advanced Practice Nursing Providers/Clinical Nurse Specialist, Women’s Health"]
[90,"Physician/Medical Oncology","207RX0202X","Allopathic & Osteopathic Physicians/Internal Medicine, Medical Oncology"]
[91,"Physician/Surgical Oncology","2086X0206X","Allopathic & Osteopathic Physicians/Surgery, Surgical Oncology"]
[92,"Physician/Radiation Oncology","2085R0001X","Allopathic & Osteopathic Physicians/Radiology, Radiation Oncology"]
[93,"Physician/Emergency Medicine","207P00000X","Allopathic & Osteopathic Physicians/Emergency Medicine"]
[93,"Physician/Emergency Medicine","207PE0004X","Allopathic & Osteopathic Physicians/Emergency Medicine, Emergency Medical Services"]
[93,"Physician/Emergency Medicine","207PH0002X","Allopathic & Osteopathic Physicians/Emergency Medicine, Hospice and Palliative Medicine"]
[93,"Physician/Emergency Medicine","207PT0002X","Allopathic & Osteopathic Physicians/Emergency Medicine, Medical Toxicology"]
[93,"Physician/Emergency Medicine","207PP0204X","Allopathic & Osteopathic Physicians/Emergency Medicine, Pediatric Emergency Medicine"]
[93,"Physician/Emergency Medicine","207PS0010X","Allopathic & Osteopathic Physicians/Emergency Medicine, Sports Medicine"]
[93,"Physician/Emergency Medicine","207PE0005X","Allopathic & Osteopathic Physicians/Emergency Medicine, Undersea and Hyperbaric Medicine"]
[94,"Physician/Interventional Radiology","2085R0204X","Allopathic & Osteopathic Physicians/Radiology, Vascular and Interventional Radiology"]
[94,"Physician/Interventional Radiology","2085H0002X","Hospice & Palliative Medicine"]
[95,"Advance Diagnostic Imaging"]
["96[5]","Optician","156FX1800X","Eye & Vision Service Providers/Technician/Technologist, Optician"]
[97,"Physician Assistant","363A00000X","Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant"]
[97,"Physician Assistant","363AM0700X","Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant, Medical"]
[97,"Physician Assistant","363AS0400X","Physician Assistants & Advanced Practice Nursing Providers/Physician Assistant, Surgical"]
[98,"Physician/Gynecological Oncology","207VX0201X","Allopathic & Osteopathic Physicians/Obstetrics & Gynecology, Gynecologic Oncology"]
[99,"Physician/Undefined Physician type[6]","208D00000X","Allopathic & Osteopathic Physicians/General Practice"]
["A0[7]","Hospital-General","282N00000X","Hospitals/General Acute Care Hospital"]
["A0[7]","Hospital-Acute Care","282N00000X","Hospitals/General Acute Care Hospital"]
["A0[7]","Hospital-Children’s (PPS excluded)","282NC2000X","Hospitals/General Acute Care Hospital, Children"]
["A0[7]","Hospital-Long-Term (PPS excluded)","282E00000X","Hospitals/Long Term Care Hospital"]
["A0[7]","Hospital-Psychiatric (PPS excluded)","283Q00000X","Hospitals/Psychiatric Hospital"]
["A0[7]","Hospital-Rehabilitation (PPS excluded)","283X00000X","Hospitals/Rehabilitation Hospital"]
["A0[7]","Hospital-Short-Term (General and Specialty)","282N00000X","Hospitals/General Acute Care Hospital"]
["A0[7]","Hospital-Short-Term (General and Specialty)","2843000000X","Hospitals/Special(ty) Hospital"]
["A0[7]","Hospital-Swing Bed Approved","275N00000X","Hospital Units/Medicare Defined Swing Bed Unit"]
["A0[7]","Hospital-Psychiatric Unit","273R00000X","Hospital Units/Psychiatric Unit"]
["A0[7]","Hospital-Rehabilitation Unit","273Y00000X","Hospital Units/Rehabilitation Unit"]
["A0[7]","Hospital-Specialty Hospital (cardiac, orthopedic, surgical)","284300000X","Hospitals/Special(ty) Hospital"]
["A0[7]","Critical Access Hospital","282NC0060X","Hospitals/General Acute Care Hospital, Critical Access"]
["A1[8]","Skilled Nursing Facility","314000000X","Nursing and Custodial Care Facilities/Skilled Nursing Facility"]
["A2[9]","Intermediate Care Nursing Facility","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
["A3[10]","Other Nursing Facility","313M00000X","Nursing and Custodial Care Facilities/Nursing Facility"]
["A4[11]","Home Health Agency","251E00000X","Agencies/Home Health"]
["A4[11]","Home Health Agency (Subunit)","251E00000X","Agencies/Home Health"]
["A5","Pharmacy","333600000X","Suppliers/Pharmacy"]
["A5","Pharmacy","3336C0002X","Suppliers/Pharmacy, Clinic Pharmacy"]
["A5","Pharmacy","3336C0003X","Suppliers/Pharmacy, Community/Retail Pharmacy"]
["A5","Pharmacy","3336C0004X","Suppliers/Pharmacy, Compounding Pharmacy"]
["A5","Pharmacy","3336H0001X","Suppliers/Pharmacy, Home Infusion Therapy Pharmacy"]
["A5","Pharmacy","3336I0012X","Suppliers/Pharmacy, Institutional Pharmacy"]
["A5","Pharmacy","3336L0003X","Suppliers/Pharmacy, Long-term Care Pharmacy"]
["A5","Pharmacy","3336M0002X","Suppliers/Pharmacy, Mail Order Pharmacy"]
["A5","Pharmacy","3336M0003X","Suppliers/Pharmacy, Managed Care Organization Pharmacy"]
["A5","Pharmacy","3336N0007X","Suppliers/Pharmacy, Nuclear Pharmacy"]
["A5","Pharmacy","3336S0011X","Suppliers/Pharmacy, Specialty Pharmacy"]
["A5","Pharmacy","1835C0205X","Suppliers/Pharmacy, Critical Care"]
["A5","Pharmacy","1835P0200X","Suppliers/Pharmacy, Pediatrics"]
["A6","Medical Supply Company with Respiratory Therapist","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
["A7","Department Store","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
["A8","Grocery Store","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
["A9[12]","Indian Health Service facility[13]"]
["B1","Oxygen supplier","332BX2000X","Suppliers/Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies"]
["B2","Pedorthic personnel","222Z00000X","Respiratory, Developmental, Rehabilitative and Restorative Service Providers/Orthotist"]
["B2","Pedorthic personnel","224P00000X","Respiratory, Developmental, Rehabilitative and Restorative Service Providers/Prosthetist"]
["B3","Medical supply company with pedorthic personnel","332B00000X","Suppliers/Durable Medical Equipment & Medical Supplies"]
["B4[14]","Rehabilitation Agency","261QR0400X","Ambulatory Health Care Facilities/Clinic/Center, Rehabilitation"]
["B4[14]","Organ Procurement Organization","335U00000X","Suppliers/Organ Procurement Organization"]
["B4[14]","Community Mental Health Center","261QM0801X","Ambulatory Health Care Facilities/Clinic/Center, Mental Health"]
["B4[14]","Comprehensive Outpatient Rehabilitation Facility","261QR0401X","Ambulatory Health Care Facilities/Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)"]
["B4[14]","End-Stage Renal Disease Facility","261QE0700X","Ambulatory Health Care Facilities/End-Stage Renal Disease (ESRD) Treatment"]
["B4[14]","Federally Qualified Health Center","261QF0400X","Ambulatory Health Care Facilities/Federally Qualified Health Center (FQHC)"]
["B4[14]","Hospice","251G00000X","Agencies/Hospice Care, Community Based"]
["B4[14]","Histocompatibility Laboratory","291U00000X","Laboratories/Clinical Medical Laboratory"]
["B4[14]","Histocompatibility Laboratory","291900000X","Laboratories/Military Clinical Medical Laboratory"]
["B4[14]","Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services","261QR0400X","Ambulatory Health Care Facilities/Clinic/Center, Rehabilitation"]
["B4[14]","Religious Non-Medical Health Care Institution","282J00000X","Hospitals/Religious Non-medical Health Care Institution"]
["B4[14]","Rural Health Clinic","261QR1300X","Ambulatory Health Care Facilities/Clinic/Center, Rural Health"]
["B5","Ocularist","156FX1700X","Eye and Vision Services Providers, Technician/Technologist, Ocularist"]
["C0","Physician/Sleep Medicine","207QS1201X","Allopathic & Osteopathic Physicians/Family Medicine, Sleep Medicine"]
["C0","Physician/Sleep Medicine","207RS0012X","Allopathic & Osteopathic Physicians/Internal Medicine, Sleep Medicine"]
["C0","Physician/Sleep Medicine","207YS0012X","Allopathic & Osteopathic Physicians/Otolaryngology/Sleep Medicine"]
["C0","Physician/Sleep Medicine","2080S0012X","Allopathic & Osteopathic Physicians/Pediatrics, Sleep Medicine"]
["C0","Physician/Sleep Medicine","2084S0012X","Allopathic & Osteopathic Physicians/ Psychiatry & Neurology, Sleep Medicine"]
["C3","Physician/Interventional Cardiology","207RI0011X","Allopathic & Osteopathic Physicians/Internal Medicine, Interventional Cardiology"]
["C5","Dentist","122300000X","Allopathic & Osteopathic Physicians/Ophthalmology, Dental Providers/Dentist"]
["C6","Physician/Hospitalist","208M00000X","Allopathic & Osteopathic Physicians/Hospitalist"]
["C7","Physician/Advanced Heart Failure and Transplant Cardiology","207RA0001X","Allopathic & Osteopathic Physicians/Advanced Heart Failure and Transplant Cardiology"]
["C8","Physician/Medical Toxicology","207PT0002X","Allopathic & Osteopathic Physicians/Emergency Medicine, Medical Toxicology"]
["C9","Hematopoietic Cell Transplantation and Cellular Therapy"]
["D1","Medicare Diabetes Preventive Program","174H00000X","Other Service Providers, Health Educator"]
["D3","Medical Genetics and Genomics","207SG0201X","Allopathic & Osteopathic Physicians/Clinical Genetics"]
["D4","Undersea and Hyperbaric Medicine","207PE0005X","Allopathic & Osteopathic Physicians/Undersea and Hyperbaric Medicine"]
["D5","Opioid Treatment Program","261QR0405X","Ambulatory Health Care Facilities/Clinic/Center, Rehabilitation"]
["D6","Home Infusion Therapy Services","336H0001X","Suppliers, Pharmacy, Home Infusion Therapy Services"]
["D7","Micrographic Dermatologic Surgery","207ND0101X","Allopathic & Osteopathic Physicians, Dermatology, MOHS-Micrographic Surgery"]
["D8","Adult Congenital Heart Disease","207RA0002X","Allopathic & Osteopathic Physicians, Internal Medicine"]
["[1] Medicare no longer enrolls this provider type."]
["[2] This is an arrangement whereby immunization services are rendered by health care providers who are under contract to the entity/individual who is enrolled in Medicare as a Mass Immunization Roster Biller. The Healthcare Provider Taxonomy Code(s) would be that (those) of the health care provider(s) who render the immunization services."]
["[3] Medicare carriers use Specialty Code 87 for Pharmacies when processing prescription drugs that are paid through the Medicare Physician Fee Schedule.  However, the description for Specialty Code 87 remains “All Other Suppliers.”"]
["[4] Because the Medicare Provider Type “Physician/Undefined Physician Type” applies to physicians, “Unknown Supplier/Provider Specialty” applies to other than physicians.  Because Medicare does not enroll every non-physician supplier/provider type in the Healthcare Provider Taxonomy Code Set, we cannot arbitrarily link this Medicare Provider Type to all remaining supplier/provider types in the Healthcare Provider Taxonomy Code Set.  In truth, this Medicare Provider Type would link to every Healthcare Provider Taxonomy Code (except those that describe physicians) that is listed in this document.  We do not list them here because doing so would greatly increase the size of this document."]
["[5] Because the Medicare Provider Type indicates that the provider/supplier is a Physician, we have linked this to the most generic Allopathic & Osteopathic Physicians classification.  It could technically link to every Allopathic & Osteopathic Physician."]
["[6] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[7] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[8] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[9] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[10] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[11] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[12] There is no linkage to specific Healthcare Provider Taxonomy Codes because an Indian Health Service facility can be various provider types/classifications."]
["[13] Medicare specialty code designation is for Part B DMEPOS purposes."]
["[14] Does not meet the definition of “health care provider” at 45 CFR 160.103; is not eligible for an NPI."]