Credentials
Every credential on file and every requirement with nothing on file, in the order work has to happen.
Download CSV
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
7 records for providers who work at Eastgate Family Care, Jefferson Park and Main Campus. Clear all filters
- Dr. Rosa DelgadoPayer enrollment: State MedicaidLapsedLapsed 20 days ago. No renewal has been recorded.No. MCD-ENR-DEMO-4156Ends Sep 17, 2026
- Nadia BrooksCAQH attestationLapsedLapsed 10 days ago. No renewal has been recorded.No. RHP-CAQH-DEMO-4042Ends Sep 27, 2026
- Dr. Aisha GrantState medical license (VA)LapsedLapsed 3 days ago. No renewal has been recorded.No. VA-LIC-DEMO-4056Ends Oct 4, 2026
- Dr. Owen HaleDEA registration (TN)ExpiringExpires in 12 days. Renewal not started.No. TN-DEA-DEMO-4006Ends Oct 19, 2026
- Dr. Hannah WeissPayer enrollment: Larkspur Health PlanPendingApplication sent Aug 28, 2026 (40 days ago) and not approved yet.No. LARK-ENR-DEMO-4088
- Dr. Nora WhitfieldPayer enrollment: Larkspur Health PlanPendingApplication sent Sep 17, 2026 (20 days ago) and not approved yet.No. LARK-ENR-DEMO-4165
- Dr. Nora WhitfieldPayer enrollment: MedicarePendingApplication sent Sep 7, 2026 (30 days ago) and not approved yet.No. MCR-ENR-DEMO-4164