Credentials
Every credential on file and every requirement with nothing on file, in the order work has to happen.
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As of
Oct 7, 2026
Pick as many as you like in each row. A record shows if it matches any pick in a row, and every row.
All typesState medical licenseDEA registrationState controlled substance registrationBoard certificationMalpractice insuranceCAQH attestationPayer enrollmentHospital or surgery center privilegesCPR / BLS certificationOIG exclusion check
All sitesEast RegionWest RegionEastgate Family CareJefferson ParkMain CampusRiverbendRiverside OrthopedicsStonebridge
53 records for providers who work at Eastgate Family Care, Jefferson Park and Riverside Orthopedics, showing 51 to 53. Clear all filters
- Dr. Ethan ColeBoard certificationCurrentCurrent. Start the renewal by Apr 6, 2029.No. RHP-BRD-DEMO-4137Ends Oct 5, 2029
- Dr. Julian MoorePayer enrollment: MedicareCurrentCurrent. Start the renewal by Dec 18, 2030.No. MCR-ENR-DEMO-4117Ends Apr 17, 2031
- Dr. Hannah WeissPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Apr 18, 2031.No. MCD-ENR-DEMO-4087Ends Aug 18, 2031