Credentials

Every credential on file and every requirement with nothing on file, in the order work has to happen.

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 statuses Needs action Lapsed Missing Expiring Pending Action due Current Not verified at source

All types State medical license DEA registration State controlled substance registration Board certification Malpractice insurance CAQH attestation Payer enrollment Hospital or surgery center privileges CPR / BLS certification OIG exclusion check

All sites East Region West Region Eastgate Family Care Jefferson Park Main Campus Riverbend Riverside Orthopedics Stonebridge

35 records for providers who work at West Region and Main Campus. Clear all filters

Dr. Rosa Delgado
Payer enrollment: State Medicaid
Lapsed
Lapsed 20 days ago. No renewal has been recorded.No. MCD-ENR-DEMO-4156Ends Sep 17, 2026
Dr. Nora Whitfield
Payer enrollment: Bluestem Mutual
Missing
Nothing on file. Visits are billed to Bluestem Mutual.
Dr. Nora Whitfield
Payer enrollment: Larkspur Health Plan
Pending
Application sent Sep 17, 2026 (20 days ago) and not approved yet.No. LARK-ENR-DEMO-4165
Dr. Nora Whitfield
Payer enrollment: Medicare
Pending
Application sent Sep 7, 2026 (30 days ago) and not approved yet.No. MCR-ENR-DEMO-4164
Dr. Lena Okafor
Payer enrollment: Medicare
Action due
Renewal work should have started 26 days ago. Revalidate by Jan 10, 2027.No. MCR-ENR-DEMO-4018Ends Jan 10, 2027
Dr. Samuel Ortiz
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Oct 30, 2026.No. LARK-ENR-DEMO-4076Ends Mar 1, 2027
Dr. Rosa Delgado
Payer enrollment: Medicare
Current
Current. Start the renewal by Nov 6, 2026.No. MCR-ENR-DEMO-4155Ends Mar 6, 2027
Caleb Foster
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Dec 9, 2026.No. HARB-ENR-DEMO-4100Ends Apr 8, 2027
Dr. Lena Okafor
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Jan 1, 2027.No. MCD-ENR-DEMO-4019Ends May 1, 2027
Dr. Owen Hale
Payer enrollment: Medicare
Current
Current. Start the renewal by Feb 8, 2027.No. MCR-ENR-DEMO-4008Ends Jun 8, 2027
Dr. Julian Moore
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Mar 31, 2027.No. HARB-ENR-DEMO-4119Ends Jul 29, 2027
Dr. Priyanka Rao
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Apr 30, 2027.No. BLUE-ENR-DEMO-4110Ends Aug 28, 2027
Dr. Owen Hale
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Apr 30, 2027.No. LARK-ENR-DEMO-4009Ends Aug 30, 2027
Dr. Lena Okafor
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Jul 9, 2027.No. BLUE-ENR-DEMO-4021Ends Nov 6, 2027
Theo Ramirez
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Sep 8, 2027.No. LARK-ENR-DEMO-4053Ends Jan 6, 2028
Dr. Priyanka Rao
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Sep 29, 2027.No. LARK-ENR-DEMO-4109Ends Jan 27, 2028
Dr. Lena Okafor
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Dec 8, 2027.No. LARK-ENR-DEMO-4020Ends Apr 6, 2028
Dr. Samuel Ortiz
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Jan 27, 2028.No. HARB-ENR-DEMO-4077Ends May 26, 2028
Dr. Aisha Grant
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Feb 21, 2028.No. MCD-ENR-DEMO-4065Ends Jun 20, 2028
Dr. Aisha Grant
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Feb 25, 2028.No. BLUE-ENR-DEMO-4067Ends Jun 25, 2028
Dr. Julian Moore
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Mar 17, 2028.No. BLUE-ENR-DEMO-4120Ends Jul 16, 2028
Caleb Foster
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Apr 27, 2028.No. LARK-ENR-DEMO-4099Ends Aug 25, 2028
Dr. Rosa Delgado
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by May 18, 2028.No. LARK-ENR-DEMO-4157Ends Sep 15, 2028
Dr. Owen Hale
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Jul 27, 2028.No. HARB-ENR-DEMO-4010Ends Nov 24, 2028
Dr. Aisha Grant
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Jul 27, 2028.No. LARK-ENR-DEMO-4066Ends Nov 24, 2028
Dr. Julian Moore
Payer enrollment: Larkspur Health Plan
Current
Current. Start the renewal by Aug 17, 2028.No. LARK-ENR-DEMO-4118Ends Dec 15, 2028
Grace Liu
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Oct 24, 2028.No. BLUE-ENR-DEMO-4133Ends Feb 21, 2029
Dr. Samuel Ortiz
Payer enrollment: Medicare
Current
Current. Start the renewal by Oct 24, 2028.No. MCR-ENR-DEMO-4075Ends Feb 21, 2029
Theo Ramirez
Payer enrollment: Harborline Health
Current
Current. Start the renewal by Dec 1, 2028.No. HARB-ENR-DEMO-4054Ends Apr 2, 2029
Dr. Samuel Ortiz
Payer enrollment: Bluestem Mutual
Current
Current. Start the renewal by Jan 12, 2029.No. BLUE-ENR-DEMO-4078Ends May 14, 2029
Caleb Foster
Payer enrollment: Medicare
Current
Current. Start the renewal by May 18, 2029.No. MCR-ENR-DEMO-4098Ends Sep 17, 2029
Dr. Priyanka Rao
Payer enrollment: Medicare
Current
Current. Start the renewal by Apr 30, 2030.No. MCR-ENR-DEMO-4108Ends Aug 28, 2030
Grace Liu
Payer enrollment: State Medicaid
Current
Current. Start the renewal by Nov 8, 2030.No. MCD-ENR-DEMO-4132Ends Mar 10, 2031
Grace Liu
Payer enrollment: Medicare
Current
Current. Start the renewal by Nov 22, 2030.No. MCR-ENR-DEMO-4131Ends Mar 24, 2031
Dr. Julian Moore
Payer enrollment: Medicare
Current
Current. Start the renewal by Dec 18, 2030.No. MCR-ENR-DEMO-4117Ends Apr 17, 2031