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 8, 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
111 records for providers who work at Eastgate Family Care, Jefferson Park, Main Campus and Stonebridge, showing 101 to 111. Clear all filters
- Dr. Samuel OrtizPayer enrollment: Bluestem MutualCurrentCurrent. Start the renewal by Jan 15, 2029.No. BLUE-ENR-DEMO-4078Ends May 15, 2029
- Dr. Ethan ColeDEA registration (TN)CurrentCurrent. Start the renewal by May 25, 2029.No. TN-DEA-DEMO-4139Ends Jul 24, 2029
- Dr. Ethan ColeBoard certificationCurrentCurrent. Start the renewal by Apr 9, 2029.No. RHP-BRD-DEMO-4137Ends Oct 6, 2029
- Dr. Owen HaleBoard certificationCurrentCurrent. Start the renewal by Jul 11, 2029.No. RHP-BRD-DEMO-4004Ends Jan 7, 2030
- Theo RamirezBoard certificationCurrentCurrent. Start the renewal by Jul 27, 2029.No. RHP-BRD-DEMO-4049Ends Jan 24, 2030
- Dr. Priyanka RaoPayer enrollment: MedicareCurrentCurrent. Start the renewal by May 1, 2030.No. MCR-ENR-DEMO-4108Ends Aug 29, 2030
- Dr. Priyanka RaoBoard certificationCurrentCurrent. Start the renewal by May 8, 2030.No. RHP-BRD-DEMO-4105Ends Nov 4, 2030
- Dr. Rosa DelgadoBoard certificationCurrentCurrent. Start the renewal by May 24, 2030.No. RHP-BRD-DEMO-4149Ends Nov 21, 2030
- Dr. Lena OkaforBoard certificationCurrentCurrent. Start the renewal by Aug 26, 2030.No. RHP-BRD-DEMO-4014Ends Feb 22, 2031
- Dr. Aisha GrantBoard certificationCurrentCurrent. Start the renewal by Sep 12, 2030.No. RHP-BRD-DEMO-4059Ends Mar 11, 2031
- Dr. Hannah WeissPayer enrollment: State MedicaidCurrentCurrent. Start the renewal by Apr 21, 2031.No. MCD-ENR-DEMO-4087Ends Aug 19, 2031