INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12658, 1006, 20087, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Galaxy Health ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Galaxy Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-09 10:29:42', '2021-06-09 10:29:42'),
(12659, 1006, 20087, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent a f/u email @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,    We wish to enroll the following group and providers with Galaxy Health, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible regarding how we should proceed.  Thank you!\"', NULL, NULL, '2021-06-24 15:40:41', '2021-06-24 15:40:41'),
(12660, 1006, 20087, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email to Daniel Marley dmarley@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,   I wanted to get an update on this request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:05:46', '2021-07-13 17:05:46'),
(12661, 11056, 20087, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 12:43:27', '2021-08-18 12:43:27'),
(12662, 11056, 20087, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com,  contracting@ghn-mci.com &  providers@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# : 1619166188  Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 10:30:15', '2021-08-24 10:30:15'),
(12663, 11056, 20087, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Ahmed,     After review, I show a personal agreement for Dr. Mercedita Flynn effective 7-1-2021. I do not show Katherine Paterson as participating under the information you provided.     Thanks,     Daniel M.  Contract Specialist  Galaxy Health Network  (P) 800-975-3322 X 1124 (F) 1-800-645-0154', NULL, NULL, '2021-09-01 13:38:18', '2021-09-01 13:38:18'),
(12664, 11056, 20087, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good morning!  Hope this email finds you well. Could you provide me with a signed copy of that agreement of the provider Dr. Mercedita Flynn? And inform me the procedure by which the provider Katherine Paterson shows as participating under the Group TIN.  If you need any documents or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-09-17 14:51:08', '2021-09-17 14:51:08'),
(12665, 11056, 20087, NULL, '2021-10-06 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hi Ahmed,  I am sorry, however, the below statement that Dr. Flynn is under a personal agreement shows to be incorrect. I show this provider, Dr. Flynn  is under a group agreement.  To confirm I do not show Katherine Paterson as presently participating with Galaxy under the Coastal Bend Urgent Care Group agreement. If the group wishes to add Katherine Paterson to their existing agreement then please see the attached.  If your company wishes a copy of the group agreement you will need to fax written authorization signed by an authorized signatory of the CBUS group stating your company Claims Med Inc is representing the group and that Galaxy is authorized to send you a copy of their agreement. That can be faxed to 817-633-5729.   Further, I show that the same information above on how to obtain a copy of the group agreement was sent to Mr. Brad Peterson who is with you company and he may already have a copy of the group agreement.', NULL, NULL, '2021-09-29 12:52:09', '2021-09-29 12:52:09'),
(12666, 11056, 20087, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good afternoon Daniel!  Hope this email finds you well. Here is the filled Physician agreement form for the provider Katherine Paterson, to add her with Galaxy under the Coastal Bend Urgent Care Group agreement. Please see the attachment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-10-07 15:03:20', '2021-10-07 15:03:20'),
(12667, 11056, 20087, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope this email finds you well.  Please provide us with the latest updates regarding the following providers under the below mentioned practice with Galaxy health as soon as possible.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a great day!', NULL, NULL, '2021-10-18 16:46:34', '2021-10-18 16:46:34'),
(12668, 11056, 20087, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : kavalos@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hello please,     provide providers specialty, phone/fax number effective date you will like.     Thanks;     Karen A  Have provided them with details', NULL, NULL, '2021-11-09 12:16:08', '2021-11-09 12:16:08'),
(12669, 11056, 20087, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon Karen!  Hope this email finds you well. Please find the information below which you have requested.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548           Ph # : 361-226-1126          fax no. : 361 542-4076 Mercedita Flynn (FNP)	1619166188          Ph # : 361-226-1126          fax no. : 361 542-4076 Monica Gonzalez (FNP)	1871132811          Ph # : 361-226-1126          fax no. : 361 542-4076  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:54:41', '2021-11-24 13:54:41'),
(12670, 11056, 20087, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:34:14', '2021-12-06 15:34:14'),
(12671, 11056, 20087, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub:  Enrollment Query - CBUC & GWMC - Galaxy Health  Enrollment Status Query - Galaxy Health - CBUC/GWMC   Is this eff date is for all of the providers or not? Provide me with welcome letters too.', NULL, NULL, '2021-12-17 14:24:58', '2021-12-17 14:24:58'),
(12672, 11056, 20087, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: Kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Enrollment Query - CBUC & GWMC - Galaxy Health   Good evening Karen!  Hope this email finds you well. Please list the highlighted location under the following provider as soon as possible. And also list all of the providers with both locations on your provider directory. I am unable to find the providers, I only found Mercedita Flynn. I have attached the SS for your concerns.    Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548              Unable to find provider on the directory Mercedita Flynn (FNP)	1619166188               Only Primary location is listed Monica Gonzalez (FNP)	1871132811              Unable to find provider on the directory  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-12-23 10:10:48', '2021-12-23 10:10:48'),
(12673, 19067, 20087, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Hello!  Hope you\'re doing well,  I would like to know the enrollment status of the following Providers & Groups with Galaxy Health.   Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:24:43', '2021-12-30 13:24:43'),
(12674, 19067, 20087, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, kavalos@ghn-mci.com, dmarley@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Greetings!  You haven\'t responded yet.  Still waiting to get the updates about the previously mentioned request.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:28:57', '2022-01-09 22:28:57'),
(12675, 19067, 20087, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Good Morning!  Hope this email finds you well.  This is my SECOND REMINDER on the below mentioned request. Kindly look into this.  Kindly respond as per your convenience.   Regards, Hammad.', NULL, NULL, '2022-01-26 11:10:11', '2022-01-26 11:10:11'),
(12676, 1019, 20087, NULL, '2022-02-09 00:00:00.000', 'In Process', 'Hello,  Can you please send me a copy of their welcome letters.     Regards, Alex', NULL, NULL, '2022-02-02 13:33:36', '2022-02-02 13:33:36'),
(12677, 19067, 20087, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email received from: kavalos@ghn-mci.com  Subject: RE: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||    Hello Ahmed;     There is no welcome letters this is not a personal agreement.', NULL, NULL, '2022-02-21 16:26:42', '2022-02-21 16:26:42'),
(12678, 20067, 20087, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Good Afternoon!  Hope you had a great weekend. I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663  Eagerly waiting to hear from you.  Thank you, ', NULL, NULL, '2022-03-07 16:56:37', '2022-03-07 16:56:37'),
(12679, 22077, 20087, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Hi,  I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Waiting to hear from you soon.  Thanks. Alex', NULL, NULL, '2022-04-13 14:26:11', '2022-04-13 14:26:11'),
(12680, 3046, 20088, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:15:43', '2021-03-12 13:15:43'),
(12681, 1006, 20088, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Sent enrollment email request @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Provider Enrollment - Galaxy Health - CBUC  \"Hello,   We wish to enroll/contract our group and providers with Galaxy Health, their information is as follows: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264  Provider Name: Katherine Paterson NPI# 1164776548 Provider Name: Jennifer Tudor NPI# 1720455835 Provider Name: Mercedita Flynn NPI# 1619166188  Please get back to me as soon as you\'re able to.   Thank you. \"', NULL, NULL, '2021-05-05 14:51:31', '2021-05-05 14:51:31'),
(12682, 1006, 20088, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Galaxy Health ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Galaxy Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-09 10:29:39', '2021-06-09 10:29:39'),
(12683, 1006, 20088, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent a f/u email @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,    We wish to enroll the following group and providers with Galaxy Health, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible regarding how we should proceed.  Thank you!\"', NULL, NULL, '2021-06-24 15:40:38', '2021-06-24 15:40:38'),
(12684, 1006, 20088, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email to Daniel Marley dmarley@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,   I wanted to get an update on this request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:05:44', '2021-07-13 17:05:44'),
(12685, 1006, 20088, NULL, '2021-08-02 00:00:00.000', 'Not Eligible', 'The provider is no longer a part of the group as per Ryan. ', NULL, NULL, '2021-07-26 09:00:07', '2021-07-26 09:00:07'),
(12686, 3046, 20089, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:15:45', '2021-03-12 13:15:45'),
(12687, 1006, 20089, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Sent enrollment email request @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Provider Enrollment - Galaxy Health - CBUC  \"Hello,   We wish to enroll/contract our group and providers with Galaxy Health, their information is as follows: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264  Provider Name: Katherine Paterson NPI# 1164776548 Provider Name: Jennifer Tudor NPI# 1720455835 Provider Name: Mercedita Flynn NPI# 1619166188  Please get back to me as soon as you\'re able to.   Thank you. \"', NULL, NULL, '2021-05-05 14:51:36', '2021-05-05 14:51:36'),
(12688, 1006, 20089, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Galaxy Health ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Galaxy Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-09 10:29:35', '2021-06-09 10:29:35'),
(12689, 1006, 20089, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent a f/u email @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,    We wish to enroll the following group and providers with Galaxy Health, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible regarding how we should proceed.  Thank you!\"', NULL, NULL, '2021-06-24 15:40:35', '2021-06-24 15:40:35'),
(12690, 1006, 20089, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email to Daniel Marley dmarley@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,   I wanted to get an update on this request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:05:41', '2021-07-13 17:05:41'),
(12691, 11056, 20089, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 12:43:19', '2021-08-18 12:43:19'),
(12692, 11056, 20089, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com,  contracting@ghn-mci.com &  providers@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# : 1619166188  Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 10:30:07', '2021-08-24 10:30:07'),
(12693, 11056, 20089, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Ahmed,     After review, I show a personal agreement for Dr. Mercedita Flynn effective 7-1-2021. I do not show Katherine Paterson as participating under the information you provided.     Thanks,     Daniel M.  Contract Specialist  Galaxy Health Network  (P) 800-975-3322 X 1124 (F) 1-800-645-0154', NULL, NULL, '2021-09-01 13:38:10', '2021-09-01 13:38:10'),
(12694, 11056, 20089, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good morning!  Hope this email finds you well. Could you provide me with a signed copy of that agreement of the provider Dr. Mercedita Flynn? And inform me the procedure by which the provider Katherine Paterson shows as participating under the Group TIN.  If you need any documents or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-09-17 14:50:52', '2021-09-17 14:50:52'),
(12695, 11056, 20089, NULL, '2021-10-06 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hi Ahmed,  I am sorry, however, the below statement that Dr. Flynn is under a personal agreement shows to be incorrect. I show this provider, Dr. Flynn  is under a group agreement.  To confirm I do not show Katherine Paterson as presently participating with Galaxy under the Coastal Bend Urgent Care Group agreement. If the group wishes to add Katherine Paterson to their existing agreement then please see the attached.  If your company wishes a copy of the group agreement you will need to fax written authorization signed by an authorized signatory of the CBUS group stating your company Claims Med Inc is representing the group and that Galaxy is authorized to send you a copy of their agreement. That can be faxed to 817-633-5729.   Further, I show that the same information above on how to obtain a copy of the group agreement was sent to Mr. Brad Peterson who is with you company and he may already have a copy of the group agreement.', NULL, NULL, '2021-09-29 12:52:03', '2021-09-29 12:52:03'),
(12696, 11056, 20089, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good afternoon Daniel!  Hope this email finds you well. Here is the filled Physician agreement form for the provider Katherine Paterson, to add her with Galaxy under the Coastal Bend Urgent Care Group agreement. Please see the attachment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-10-07 15:04:58', '2021-10-07 15:04:58'),
(12697, 11056, 20089, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope this email finds you well.  Please provide us with the latest updates regarding the following providers under the below mentioned practice with Galaxy health as soon as possible.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a great day!', NULL, NULL, '2021-10-18 16:46:28', '2021-10-18 16:46:28'),
(12698, 11056, 20089, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : kavalos@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hello please,     provide providers specialty, phone/fax number effective date you will like.     Thanks;     Karen A  Have provided them with details', NULL, NULL, '2021-11-09 12:16:00', '2021-11-09 12:16:00'),
(12699, 11056, 20089, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon Karen!  Hope this email finds you well. Please find the information below which you have requested.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548           Ph # : 361-226-1126          fax no. : 361 542-4076 Mercedita Flynn (FNP)	1619166188          Ph # : 361-226-1126          fax no. : 361 542-4076 Monica Gonzalez (FNP)	1871132811          Ph # : 361-226-1126          fax no. : 361 542-4076  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:54:35', '2021-11-24 13:54:35'),
(12700, 11056, 20089, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:34:07', '2021-12-06 15:34:07'),
(12701, 11056, 20089, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub:  Enrollment Query - CBUC & GWMC - Galaxy Health  Enrollment Status Query - Galaxy Health - CBUC/GWMC   Is this eff date is for all of the providers or not? Provide me with welcome letters too.', NULL, NULL, '2021-12-17 14:25:15', '2021-12-17 14:25:15'),
(12702, 11056, 20089, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: Kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Enrollment Query - CBUC & GWMC - Galaxy Health   Good evening Karen!  Hope this email finds you well. Please list the highlighted location under the following provider as soon as possible. And also list all of the providers with both locations on your provider directory. I am unable to find the providers, I only found Mercedita Flynn. I have attached the SS for your concerns.    Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548              Unable to find provider on the directory Mercedita Flynn (FNP)	1619166188               Only Primary location is listed Monica Gonzalez (FNP)	1871132811              Unable to find provider on the directory  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-12-23 10:10:44', '2021-12-23 10:10:44'),
(12703, 19067, 20089, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Hello!  Hope you\'re doing well,  I would like to know the enrollment status of the following Providers & Groups with Galaxy Health.   Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:24:48', '2021-12-30 13:24:48'),
(12704, 19067, 20089, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, kavalos@ghn-mci.com, dmarley@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Greetings!  You haven\'t responded yet.  Still waiting to get the updates about the previously mentioned request.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:28:49', '2022-01-09 22:28:49'),
(12705, 19067, 20089, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Good Morning!  Hope this email finds you well.  This is my SECOND REMINDER on the below mentioned request. Kindly look into this.  Kindly respond as per your convenience.   Regards, Hammad.', NULL, NULL, '2022-01-26 11:10:23', '2022-01-26 11:10:23'),
(12706, 1019, 20089, NULL, '2022-02-09 00:00:00.000', 'In Process', 'Hello,  Can you please send me a copy of their welcome letters.     Regards, Alex', NULL, NULL, '2022-02-02 13:33:27', '2022-02-02 13:33:27'),
(12707, 19067, 20089, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email received from: kavalos@ghn-mci.com  Subject: RE: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||    Hello Ahmed;     There is no welcome letters this is not a personal agreement.', NULL, NULL, '2022-02-21 16:27:22', '2022-02-21 16:27:22'),
(12708, 20067, 20089, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Good Afternoon!  Hope you had a great weekend. I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663  Eagerly waiting to hear from you.  Thank you, ', NULL, NULL, '2022-03-07 16:56:31', '2022-03-07 16:56:31'),
(12709, 22077, 20089, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Hi,  I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Waiting to hear from you soon.  Thanks. Alex', NULL, NULL, '2022-04-13 14:24:35', '2022-04-13 14:24:35'),
(12710, 3046, 20090, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:16:48', '2021-03-12 13:16:48'),
(12711, 1006, 20090, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Sent enrollment email request @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Provider Enrollment - Galaxy Health - CBUC  \"Hello,   We wish to enroll/contract our group and providers with Galaxy Health, their information is as follows: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264  Provider Name: Katherine Paterson NPI# 1164776548 Provider Name: Jennifer Tudor NPI# 1720455835 Provider Name: Mercedita Flynn NPI# 1619166188  Please get back to me as soon as you\'re able to.   Thank you. \"', NULL, NULL, '2021-05-05 14:51:41', '2021-05-05 14:51:41'),
(12712, 1006, 20090, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Email sent to: contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Galaxy Health ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Galaxy Health for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-09 10:29:28', '2021-06-09 10:29:28'),
(12713, 1006, 20090, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent a f/u email @ contracting@ghn-mci.com & providers@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,    We wish to enroll the following group and providers with Galaxy Health, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible regarding how we should proceed.  Thank you!\"', NULL, NULL, '2021-06-24 15:40:32', '2021-06-24 15:40:32'),
(12714, 1006, 20090, NULL, '2021-07-20 00:00:00.000', 'In Process', 'Sent f/u email to Daniel Marley dmarley@ghn-mci.com:  Sub: Enrollment Request - CBUC/GWMC - Galaxy Health  \"Hello,   I wanted to get an update on this request, please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-07-13 17:05:38', '2021-07-13 17:05:38'),
(12715, 11056, 20090, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you have any questions or concerns or need documents please let me know.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 12:43:12', '2021-08-18 12:43:12'),
(12716, 11056, 20090, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com,  contracting@ghn-mci.com &  providers@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope you are doing well. I want to inquire about the enrollment status of the below mentioned practice and providers. Please respond to me soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# : 1619166188  Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-24 10:30:00', '2021-08-24 10:30:00'),
(12717, 11056, 20090, NULL, '2021-09-08 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Ahmed,     After review, I show a personal agreement for Dr. Mercedita Flynn effective 7-1-2021. I do not show Katherine Paterson as participating under the information you provided.     Thanks,     Daniel M.  Contract Specialist  Galaxy Health Network  (P) 800-975-3322 X 1124 (F) 1-800-645-0154', NULL, NULL, '2021-09-01 13:38:04', '2021-09-01 13:38:04'),
(12718, 11056, 20090, NULL, '2021-09-24 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good morning!  Hope this email finds you well. Could you provide me with a signed copy of that agreement of the provider Dr. Mercedita Flynn? And inform me the procedure by which the provider Katherine Paterson shows as participating under the Group TIN.  If you need any documents or information feel free to reach out to me. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-09-17 14:50:45', '2021-09-17 14:50:45'),
(12719, 11056, 20090, NULL, '2021-10-06 00:00:00.000', 'In Process', 'Email received from : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hi Ahmed,  I am sorry, however, the below statement that Dr. Flynn is under a personal agreement shows to be incorrect. I show this provider, Dr. Flynn  is under a group agreement.  To confirm I do not show Katherine Paterson as presently participating with Galaxy under the Coastal Bend Urgent Care Group agreement. If the group wishes to add Katherine Paterson to their existing agreement then please see the attached.  If your company wishes a copy of the group agreement you will need to fax written authorization signed by an authorized signatory of the CBUS group stating your company Claims Med Inc is representing the group and that Galaxy is authorized to send you a copy of their agreement. That can be faxed to 817-633-5729.   Further, I show that the same information above on how to obtain a copy of the group agreement was sent to Mr. Brad Peterson who is with you company and he may already have a copy of the group agreement.', NULL, NULL, '2021-09-29 12:51:57', '2021-09-29 12:51:57'),
(12720, 11056, 20090, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC   Good afternoon Daniel!  Hope this email finds you well. Here is the filled Physician agreement form for the provider Katherine Paterson, to add her with Galaxy under the Coastal Bend Urgent Care Group agreement. Please see the attachment.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# : 1164776548  If you have any questions or concerns or need documents please let me know. Waiting to hear from you soon.  Thank you! Have a great week ahead!', NULL, NULL, '2021-10-07 15:05:05', '2021-10-07 15:05:05'),
(12721, 11056, 20090, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to : dmarley@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good morning!  Hope this email finds you well.  Please provide us with the latest updates regarding the following providers under the below mentioned practice with Galaxy health as soon as possible.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help.  Thank you! Have a great day!', NULL, NULL, '2021-10-18 16:46:19', '2021-10-18 16:46:19'),
(12722, 11056, 20090, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : kavalos@ghn-mci.com  Sub : Enrollment Status Query - Galaxy Health - CBUC/GWMC  Hello please,     provide providers specialty, phone/fax number effective date you will like.     Thanks;     Karen A  Have provided them with details', NULL, NULL, '2021-11-09 12:15:54', '2021-11-09 12:15:54'),
(12723, 11056, 20090, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Good afternoon Karen!  Hope this email finds you well. Please find the information below which you have requested.   Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548           Ph # : 361-226-1126          fax no. : 361 542-4076 Mercedita Flynn (FNP)	1619166188          Ph # : 361-226-1126          fax no. : 361 542-4076 Monica Gonzalez (FNP)	1871132811          Ph # : 361-226-1126          fax no. : 361 542-4076  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-11-24 13:54:29', '2021-11-24 13:54:29'),
(12724, 11056, 20090, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:33:18', '2021-12-06 15:33:18'),
(12725, 11056, 20090, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email sent to:  Kavalos@ghn-mci.com  Sub: Demographic Updates Needed - StatCare Minor Emergency Clinic - Galaxy Health   Good afternoon!  It was nice talking to you.  Tones of thanks to you. Kindly do provide me with the facility agreement as well for the facility.  Your efforts and assistance are highly appreciated.   Take Care!', NULL, NULL, '2021-12-06 15:34:02', '2021-12-06 15:34:02'),
(12726, 11056, 20090, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub:  Enrollment Query - CBUC & GWMC - Galaxy Health  Enrollment Status Query - Galaxy Health - CBUC/GWMC   Is this eff date is for all of the providers or not? Provide me with welcome letters too.', NULL, NULL, '2021-12-17 14:25:21', '2021-12-17 14:25:21');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12727, 11056, 20090, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: Kavalos@ghn-mci.com  Sub: Enrollment Status Query - Galaxy Health - CBUC/GWMC  Enrollment Query - CBUC & GWMC - Galaxy Health   Good evening Karen!  Hope this email finds you well. Please list the highlighted location under the following provider as soon as possible. And also list all of the providers with both locations on your provider directory. I am unable to find the providers, I only found Mercedita Flynn. I have attached the SS for your concerns.    Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name & Specialities	NPI  & COntact & Fax no.  Katherine Paterson  (FNP)	1164776548              Unable to find provider on the directory Mercedita Flynn (FNP)	1619166188               Only Primary location is listed Monica Gonzalez (FNP)	1871132811              Unable to find provider on the directory  If you have any additional questions or need documents please let me know.  Thank you! Have a great day!', NULL, NULL, '2021-12-23 10:10:39', '2021-12-23 10:10:39'),
(12728, 19067, 20090, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Hello!  Hope you\'re doing well,  I would like to know the enrollment status of the following Providers & Groups with Galaxy Health.   Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:24:31', '2021-12-30 13:24:31'),
(12729, 19067, 20090, NULL, '2022-01-17 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, kavalos@ghn-mci.com, dmarley@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Greetings!  You haven\'t responded yet.  Still waiting to get the updates about the previously mentioned request.  Thanks & Regards, Hammad Ahmed.', NULL, NULL, '2022-01-09 22:28:44', '2022-01-09 22:28:44'),
(12730, 19067, 20090, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com, dmarley@ghn-mci.com, contracting@ghn-mci.com, providers@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||   Good Morning!  Hope this email finds you well.  This is my SECOND REMINDER on the below mentioned request. Kindly look into this.  Kindly respond as per your convenience.   Regards, Hammad.', NULL, NULL, '2022-01-26 11:09:57', '2022-01-26 11:09:57'),
(12731, 1019, 20090, NULL, '2022-02-09 00:00:00.000', 'In Process', 'Hello,  Can you please send me a copy of their welcome letters.     Regards, Alex', NULL, NULL, '2022-02-02 13:33:19', '2022-02-02 13:33:19'),
(12732, 19067, 20090, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email received from: kavalos@ghn-mci.com  Subject: RE: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||    Hello Ahmed;     There is no welcome letters this is not a personal agreement.', NULL, NULL, '2022-02-21 16:26:33', '2022-02-21 16:26:33'),
(12733, 20067, 20090, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Sub: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Good Afternoon!  Hope you had a great weekend. I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663 Monica Gonzalez	1871132811	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Monica Gonzalez	1871132811	504A Houston Street Live Oak County, George West, TX 78022-3663 Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663 Mercedita Flynn	1619166188	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Mercedita Flynn	1619166188	504A Houston Street Live Oak County, George West, TX 78022-3663  Eagerly waiting to hear from you.  Thank you, ', NULL, NULL, '2022-03-07 16:56:24', '2022-03-07 16:56:24'),
(12734, 22077, 20090, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: kavalos@ghn-mci.com  Subject: Re: Enrollment Query || CBUC & GWMC || Providers & Groups || Galaxy Health ||  Hi,  I would like to know the credentialing status of the listed providers with locations. If any of them are credentialed, kindly send the roster with effective dates.  Waiting to hear from you soon.  Thanks. Alex', NULL, NULL, '2022-04-13 14:25:46', '2022-04-13 14:25:46'),
(12735, 3046, 20091, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:18:37', '2021-03-12 13:18:37'),
(12736, 3040, 20091, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Health Smart for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 10:57:41', '2021-06-07 10:57:41'),
(12737, 1006, 20091, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers and if we need to enroll them then what is required to proceed, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264  Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-24 16:00:57', '2021-06-24 16:00:57'),
(12738, 1006, 20091, NULL, '2021-07-20 00:00:00.000', 'In Process', 'We received the following update from Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hi,  1. Our system has been updated as requested.  Providers Name Flynn, Mercedita N Tudor, Jennifer M  * The locations below have been added.  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.  *Katherine Paterson  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks Healthsmart Provider Relations.\"  Sent reply:  \"Hello,   I appreciate the update, can you please let me know what the effective dates are for the following providers:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Thank you. \"', NULL, NULL, '2021-07-13 17:10:47', '2021-07-13 17:10:47'),
(12739, 11056, 20091, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com  Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you need any documents or information regarding this feel free to contact me.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 13:48:28', '2021-08-18 13:48:28'),
(12740, 11056, 20091, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com & mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 09:36:23', '2021-08-24 09:36:23'),
(12741, 11056, 20091, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com    Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  & Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  1. Our system has been updated as requested.  * The locations below have been added.  Provider \"FLYNN, MERCEDITA N\" effective date is \" 09/01/2017 \".  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.   * Katherine Paterson.  3. Provider \" Gonzalez, Monica Del Bosque NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID :85450)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-09-01 14:55:50', '2021-09-01 14:55:50'),
(12742, 11056, 20091, NULL, '2021-09-21 00:00:00.000', 'Approved', 'Email received from : mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  1. Our system has been updated as requested.  * The locations below have been added.  Provider \"FLYNN, MERCEDITA N\" effective date is \" 09/01/2017 \".   Please see the attachment.', NULL, NULL, '2021-09-14 12:26:22', '2021-09-14 12:26:22'),
(12743, 3046, 20092, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:18:39', '2021-03-12 13:18:39'),
(12744, 3040, 20092, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Health Smart for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 10:57:44', '2021-06-07 10:57:44'),
(12745, 1006, 20092, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers and if we need to enroll them then what is required to proceed, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264  Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-24 16:00:54', '2021-06-24 16:00:54'),
(12746, 1006, 20092, NULL, '2021-07-21 00:00:00.000', 'In Process', 'We received the following update from Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hi,  1. Our system has been updated as requested.  Providers Name Flynn, Mercedita N Tudor, Jennifer M  * The locations below have been added.  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.  *Katherine Paterson  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks Healthsmart Provider Relations.\"  Replied with:  \"Hello,   Please find the attached CAQH access form for Katherine Paterson, do let me know if anything else is required to proceed with this request.  Thank you. \"', NULL, NULL, '2021-07-14 10:19:59', '2021-07-14 10:19:59'),
(12747, 11056, 20092, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com  Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you need any documents or information regarding this feel free to contact me.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 13:48:15', '2021-08-18 13:48:15'),
(12748, 11056, 20092, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com & mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 09:36:15', '2021-08-24 09:36:15'),
(12749, 11056, 20092, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com    Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  & Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  1. Our system has been updated as requested.  * The locations below have been added.  Provider \"FLYNN, MERCEDITA N\" effective date is \" 09/01/2017 \".  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.   * Katherine Paterson.  3. Provider \" Gonzalez, Monica Del Bosque NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID :85450)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-09-01 14:55:45', '2021-09-01 14:55:45'),
(12750, 11056, 20092, NULL, '2021-09-21 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  -Thank you for your submission. The application has been forwarded to credentialing. Please follow up in 30 days for a status Paterson, Katherine D NP  -Provider \" Gonzalez, Monica Del Bosque NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-09-14 12:37:14', '2021-09-14 12:37:14'),
(12751, 11056, 20092, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com  Sub : fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Hi,  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \".  02- Provider \" Paterson, Katherine D NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 85450)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-09-27 10:50:07', '2021-09-27 10:50:07'),
(12752, 11056, 20092, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good morning!  Hope you had a great and safe weekend. Please assist with the below at your earliest opportunity.  (Inventory Log ID : 85450)  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \": Please provide us with the welcome letter for the provider  02- Provider \" Paterson, Katherine D NP \" : Provide the latest updates on the credentialing process of the provider.  If you need any documents or information or have any concerns please do not hesitate to contact me.   Thank you! Have a blessed day!', NULL, NULL, '2021-10-06 14:36:55', '2021-10-06 14:36:55'),
(12753, 11056, 20092, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email sent to : mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Good morning!  Hope you had a great and safe weekend. Please assist with the below at your earliest opportunity.  (Inventory Log ID : 85450)  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \": Please provide us with the welcome letter for the provider  02- Provider \" Paterson, Katherine D NP \" : Provide the latest updates on the credentialing process of the provider.  If you need any documents or information or have any concerns please do not hesitate to contact me.   Thank you! Have a blessed day!', NULL, NULL, '2021-10-14 14:48:55', '2021-10-14 14:48:55'),
(12754, 11056, 20092, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters have not been completed for the providers effective 10/1. Please allow 2-3 weeks.    Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions 6303 Commerce Drive | Suite 180 | Irving, TX 75039 pr.south@healthsmart.com | www.HealthSmart.com ', NULL, NULL, '2021-10-22 09:07:33', '2021-10-22 09:07:33'),
(12755, 11056, 20092, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters will be generated and go out this week.     Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 14:02:13', '2021-11-09 14:02:13'),
(12756, 11056, 20092, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to:   pr.south@healthsmart.com  Sub:  Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good afternoon!  Hope this email finds you well. Kindly, provide updates on the credentialing application of the provider, Katherine Paterson.  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help  Thank you! Have a wonderful day! ', NULL, NULL, '2021-11-24 10:32:25', '2021-11-24 10:32:25'),
(12757, 11056, 20092, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub: Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Hi,  Provider \" Paterson, Katherine D NP \" is currently in the credentialing process.  All communication, including requested documents, should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-12-06 15:47:37', '2021-12-06 15:47:37'),
(12758, 11056, 20092, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub:  Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good afternoon!  Hope all is well with you. I want to get the latest updates on the credentialing process of the provider, Katherine Paterson. ( NPI: 1164776548 )  If you require any information or documents or have any queries, I will be at your service.  Thank you! Have a great day!', NULL, NULL, '2021-12-17 15:56:46', '2021-12-17 15:56:46'),
(12759, 11056, 20092, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters have not been completed for the providers effective 10/1. Please allow 2-3 weeks.    Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions 6303 Commerce Drive | Suite 180 | Irving, TX 75039 pr.south@healthsmart.com | www.HealthSmart.com ', NULL, NULL, '2021-12-22 11:00:29', '2021-12-22 11:00:29'),
(12760, 19067, 20092, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Katherine Paterson || Health Smart ||   Hello!  Hope you\'re doing well.  I would like to know the enrollment status of the following provider and if the provider is enrolled provide us with the Welcome pack. That would be very helpful for us.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Katherine Paterson	1164776548	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Katherine Paterson	1164776548	504A Houston Street Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:36:10', '2021-12-30 13:36:10'),
(12761, 19067, 20092, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 09:50:34', '2022-01-03 09:50:34'),
(12762, 19067, 20092, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||    Hi,  Please send the list of providers affected by this update,  Provider Name Provider NPI #  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-03 09:54:44', '2022-01-03 09:54:44'),
(12763, 19067, 20092, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Re: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good Morning!  I hope you enjoyed the holidays and having a great new year!  I would like to know the enrollment status of the following Group.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663  Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811 Leticia Ann Aleman-Listenbee	1154999654 Frank Dehnsich	1952376345 Jennifer Tudor	1720455835    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 10:01:31', '2022-01-03 10:01:31'),
(12764, 19067, 20092, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Katherine D Paterson, NP   02/01/2022   Mercedita Nening Flynn, NP   09/01/2017   Monica D Gonzalez, NP   10/01/2021   Frank Raymond Dehnisch, Jr, MD   09/01/2017   Jennifer Marrie Tudor, NP   09/01/2017    02- Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-05 11:51:37', '2022-01-05 11:51:37'),
(12765, 19067, 20092, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Re: Enrollment Query || CBUC & GWMC || Leticia Aleman-Listenbee || Health Smart ||  Greetings!  Any updates on mentioned request?  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-12 14:02:41', '2022-01-12 14:02:41'),
(12766, 19067, 20092, NULL, '2022-02-02 00:00:00.000', 'Approved', 'See attachment of Provider\'s Directory as a reference.', NULL, NULL, '2022-01-26 11:26:55', '2022-01-26 11:26:55'),
(12767, 19067, 20092, NULL, '2022-02-18 00:00:00.000', 'Approved', 'Welcome letter.', NULL, NULL, '2022-02-11 09:38:10', '2022-02-11 09:38:10'),
(12768, 3046, 20093, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:18:40', '2021-03-12 13:18:40'),
(12769, 3040, 20093, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Health Smart for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 10:57:48', '2021-06-07 10:57:48'),
(12770, 1006, 20093, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers and if we need to enroll them then what is required to proceed, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264  Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-24 16:00:51', '2021-06-24 16:00:51'),
(12771, 1006, 20093, NULL, '2021-07-20 00:00:00.000', 'In Process', 'We received the following update from Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hi,  1. Our system has been updated as requested.  Providers Name Flynn, Mercedita N Tudor, Jennifer M  * The locations below have been added.  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.  *Katherine Paterson  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks Healthsmart Provider Relations.\"  Sent reply:  \"Hello,   I appreciate the update, can you please let me know what the effective dates are for the following providers:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Thank you. \"', NULL, NULL, '2021-07-13 17:10:43', '2021-07-13 17:10:43'),
(12772, 1006, 20093, NULL, '2021-08-02 00:00:00.000', 'Not Eligible', 'The provider is no longer a part of the group as per Ryan. ', NULL, NULL, '2021-07-26 09:00:13', '2021-07-26 09:00:13'),
(12773, 3046, 20094, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:18:42', '2021-03-12 13:18:42'),
(12774, 3040, 20094, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned group and providers in Health Smart for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 10:57:52', '2021-06-07 10:57:52'),
(12775, 1006, 20094, NULL, '2021-07-01 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hello,  I wanted to get an update regarding the enrollment status for the following group and providers and if we need to enroll them then what is required to proceed, their information is as follows:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264  Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Provider Name: Katherine Paterson Provider NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-06-24 16:00:41', '2021-06-24 16:00:41'),
(12776, 1006, 20094, NULL, '2021-07-20 00:00:00.000', 'In Process', 'We received the following update from Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - CBUC/GWMC - Health Smart  \"Hi,  1. Our system has been updated as requested.  Providers Name Flynn, Mercedita N Tudor, Jennifer M  * The locations below have been added.  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.  *Katherine Paterson  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks Healthsmart Provider Relations.\"  Sent reply:  \"Hello,   I appreciate the update, can you please let me know what the effective dates are for the following providers:  Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Thank you. \"', NULL, NULL, '2021-07-13 17:10:40', '2021-07-13 17:10:40'),
(12777, 11056, 20094, NULL, '2021-08-25 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com  Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  If you need any documents or information regarding this feel free to contact me.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 13:48:05', '2021-08-18 13:48:05'),
(12778, 11056, 20094, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com & mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Good morning!  Hope all is well. Could you please provide me the effective dates and welcome or approval letter for the following providers and practice soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you need any documents or information regarding this feel free to contact me. Waiting to hear from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 09:36:09', '2021-08-24 09:36:09'),
(12779, 11056, 20094, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com    Sub : Enrollment Status Updates - CBUC/GWMC - Health Smart  & Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  1. Our system has been updated as requested.  * The locations below have been added.  Provider \"FLYNN, MERCEDITA N\" effective date is \" 09/01/2017 \".  2. Below provider not found in the system please fill out the attached CAQH Access form and send W9 so that we can process your request.   * Katherine Paterson.  3. Provider \" Gonzalez, Monica Del Bosque NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID :85450)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-09-01 14:55:39', '2021-09-01 14:55:39'),
(12780, 11056, 20094, NULL, '2021-09-21 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Hi,  -Thank you for your submission. The application has been forwarded to credentialing. Please follow up in 30 days for a status Paterson, Katherine D NP  -Provider \" Gonzalez, Monica Del Bosque NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 81433)  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-09-14 12:37:06', '2021-09-14 12:37:06'),
(12781, 11056, 20094, NULL, '2021-10-04 00:00:00.000', 'In Process', 'Email received from : mdiprsupport@healthsmart.com  Sub : fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Hi,  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \".  02- Provider \" Paterson, Katherine D NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 85450)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-09-27 10:49:59', '2021-09-27 10:49:59'),
(12782, 11056, 20094, NULL, '2021-10-13 00:00:00.000', 'In Process', 'Email sent to : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good morning!  Hope you had a great and safe weekend. Please assist with the below at your earliest opportunity.  (Inventory Log ID : 85450)  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \": Please provide us with the welcome letter for the provider  02- Provider \" Paterson, Katherine D NP \" : Provide the latest updates on the credentialing process of the provider.  If you need any documents or information or have any concerns please do not hesitate to contact me.   Thank you! Have a blessed day!', NULL, NULL, '2021-10-06 14:36:45', '2021-10-06 14:36:45'),
(12783, 11056, 20094, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email sent to : mdiprsupport@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Good morning!  Hope you had a great and safe weekend. Please assist with the below at your earliest opportunity.  (Inventory Log ID : 85450)  01- Provider \" Monica D Gonzalez, NP \" is effective date \" 10/01/2021 \": Please provide us with the welcome letter for the provider  02- Provider \" Paterson, Katherine D NP \" : Provide the latest updates on the credentialing process of the provider.  If you need any documents or information or have any concerns please do not hesitate to contact me.   Thank you! Have a blessed day!', NULL, NULL, '2021-10-14 14:48:49', '2021-10-14 14:48:49'),
(12784, 11056, 20094, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters have not been completed for the providers effective 10/1. Please allow 2-3 weeks.    Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions 6303 Commerce Drive | Suite 180 | Irving, TX 75039 pr.south@healthsmart.com | www.HealthSmart.com ', NULL, NULL, '2021-10-22 09:07:27', '2021-10-22 09:07:27'),
(12785, 11056, 20094, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters will be generated and go out this week.     Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions  222 W Las Colinas Blvd | Suite 500N | Irving, TX 75039', NULL, NULL, '2021-11-09 14:02:08', '2021-11-09 14:02:08'),
(12786, 11056, 20094, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email sent to:   pr.south@healthsmart.com  Sub:  Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good afternoon!  Hope this email finds you well. Kindly, provide updates on the credentialing application of the provider, Katherine Paterson.  Please do not hesitate to contact me directly, if you have any questions or concerns I am happy to help  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-24 10:32:52', '2021-11-24 10:32:52'),
(12787, 11056, 20094, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Sub: Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart   Hi,  Provider \" Paterson, Katherine D NP \" is currently in the credentialing process.  All communication, including requested documents, should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-12-06 15:47:31', '2021-12-06 15:47:31'),
(12788, 11056, 20094, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Sub:  Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Good afternoon!  Hope all is well with you. I want to get the latest updates on the credentialing process of the provider, Katherine Paterson. ( NPI: 1164776548 )  If you require any information or documents or have any queries, I will be at your service.  Thank you! Have a great day!', NULL, NULL, '2021-12-17 15:56:41', '2021-12-17 15:56:41'),
(12789, 11056, 20094, NULL, '2021-12-29 00:00:00.000', 'In Process', 'Email received from : pr.south@healthsmart.com  Sub : Fwd: Fw: Enrollment Status - CBUC/GWMC - Health Smart  Welcome letters have not been completed for the providers effective 10/1. Please allow 2-3 weeks.    Diamond Lucero |Sr. Provider Relations  HealthSmart | Network Solutions 6303 Commerce Drive | Suite 180 | Irving, TX 75039 pr.south@healthsmart.com | www.HealthSmart.com ', NULL, NULL, '2021-12-22 11:00:21', '2021-12-22 11:00:21'),
(12790, 19067, 20094, NULL, '2022-01-06 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2021-12-30 13:44:50', '2021-12-30 13:44:50'),
(12791, 19067, 20094, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, pr.south@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hello!  Hope you are doing well.  I would like to know the enrollment status of the following Groups.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, Live Oak County, George West, TX 78022-3663   Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 09:50:27', '2022-01-03 09:50:27'),
(12792, 19067, 20094, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||    Hi,  Please send the list of providers affected by this update,  Provider Name Provider NPI #  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-03 09:54:15', '2022-01-03 09:54:15'),
(12793, 19067, 20094, NULL, '2022-01-10 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Re: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good Morning!  I hope you enjoyed the holidays and having a great new year!  I would like to know the enrollment status of the following Group.  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663  Provider Name	NPI Katherine Paterson	1164776548 Mercedita Flynn	1619166188 Monica Gonzalez	1871132811 Leticia Ann Aleman-Listenbee	1154999654 Frank Dehnsich	1952376345 Jennifer Tudor	1720455835    Thanks & Regards, Ahmed, Hammad.', NULL, NULL, '2022-01-03 10:01:25', '2022-01-03 10:01:25'),
(12794, 19067, 20094, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email received from: mdiprsupport@healthsmart.com  Subject: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Katherine D Paterson, NP   02/01/2022   Mercedita Nening Flynn, NP   09/01/2017   Monica D Gonzalez, NP   10/01/2021   Frank Raymond Dehnisch, Jr, MD   09/01/2017   Jennifer Marrie Tudor, NP   09/01/2017    02- Provider \" Aleman-Listenbee, Leticia A NP \" is currently in the credentialing process.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2022-01-05 11:51:49', '2022-01-05 11:51:49'),
(12795, 19067, 20094, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Re: Fw: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Greetings!  Can you please send the welcome letters?   That would be very helpful.  Regards, Hammad Ahmed.', NULL, NULL, '2022-01-12 13:57:38', '2022-01-12 13:57:38'),
(12796, 19067, 20094, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Re: Fw: Fw: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good Morning!  Hope this email finds you well. Can you please provide us with the welcome kit for the group, Coastal Bend Urgent Care & George West Medical Center.  Waiting for your response.  Regards, Hammad.', NULL, NULL, '2022-01-26 13:15:07', '2022-01-26 13:15:07'),
(12797, 20067, 20094, NULL, '2022-03-14 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Sub: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||   Good evening!  Hope you had a great weekend. Can you please help me out with the credentialing status of the listed provider under both locations?  Group Name	Beeville Medical Clinic Tax ID	81-1890349 Group NPI	1427509264 Provider Name	NPI	Location Leticia Aleman-Listenbee	1154999654	301 S HILLSIDE DR STE 4 BEEVILLE, TX 78102-5324 Leticia Aleman-Listenbee	1154999654	504A Houston Street Live Oak County, George West, TX 78022-3663   Thank you, Syed Ahad.', NULL, NULL, '2022-03-07 17:06:07', '2022-03-07 17:06:07');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12798, 22077, 20094, NULL, '2022-04-20 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: 	Re: Enrollment Query || CBUC & GWMC || Groups || Health Smart ||  Hi,  Any updates on the request mentioned previously?  Thanks. ', NULL, NULL, '2022-04-13 14:35:57', '2022-04-13 14:35:57'),
(12799, 3046, 20095, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:21:03', '2021-03-12 13:21:03'),
(12800, 1006, 20095, NULL, '2021-06-11 00:00:00.000', 'Initiated', 'I had the following discussion with Humana:  Group: Medicare  Medicare PPO  Humana PPO ChoiceCare PPO  Eff: 06/01/2019  Requested group contract for reference. ', NULL, NULL, '2021-06-04 16:22:09', '2021-06-04 16:22:09'),
(12801, 1006, 20095, NULL, '2021-06-16 00:00:00.000', 'Approved', 'Executed group contract received and attached for reference. ', NULL, NULL, '2021-06-09 10:40:29', '2021-06-09 10:40:29'),
(12802, 3046, 20096, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:21:42', '2021-03-12 13:21:42'),
(12803, 1006, 20096, NULL, '2021-05-12 00:00:00.000', 'Approved', 'Group is enrolled with Medicaid, proof of enrollment is attached for reference.   EFF: 07/03/2017 ', NULL, NULL, '2021-05-05 15:34:36', '2021-05-05 15:34:36'),
(12804, 3046, 20097, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:23:52', '2021-03-12 13:23:52'),
(12805, 1005, 20097, NULL, '2021-06-10 00:00:00.000', 'Approved', 'Approval confirmation attached.', NULL, NULL, '2021-06-03 13:05:01', '2021-06-03 13:05:01'),
(12806, 3046, 20098, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:23:54', '2021-03-12 13:23:54'),
(12807, 1005, 20098, NULL, '2021-06-10 00:00:00.000', 'Approved', 'Approval proof attached.', NULL, NULL, '2021-06-03 13:02:32', '2021-06-03 13:02:32'),
(12808, 3046, 20099, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:23:56', '2021-03-12 13:23:56'),
(12809, 1006, 20099, NULL, '2021-05-12 00:00:00.000', 'Approved', 'Group is enrolled with Medicare, proof of enrollment is attached for reference.  EFF: 07/03/2017', NULL, NULL, '2021-05-05 15:33:37', '2021-05-05 15:33:37'),
(12810, 3046, 20100, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:27:17', '2021-03-12 13:27:17'),
(12811, 1005, 20100, NULL, '2021-06-10 00:00:00.000', 'Approved', 'Approval confirmation attached.', NULL, NULL, '2021-06-03 13:35:33', '2021-06-03 13:35:33'),
(12812, 3046, 20101, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:27:18', '2021-03-12 13:27:18'),
(12813, 1005, 20101, NULL, '2021-06-10 00:00:00.000', 'Approved', 'Approval confirmation attached.', NULL, NULL, '2021-06-03 13:33:03', '2021-06-03 13:33:03'),
(12814, 3046, 20102, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:27:19', '2021-03-12 13:27:19'),
(12815, 1005, 20102, NULL, '2021-06-10 00:00:00.000', 'Approved', 'Approval confirmation attached.', NULL, NULL, '2021-06-03 13:32:35', '2021-06-03 13:32:35'),
(12816, 3046, 20126, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:35:38', '2021-03-12 13:35:38'),
(12817, 3040, 20126, NULL, '2021-06-14 00:00:00.000', 'Not Eligible', 'We received the following Network Denial/Rejection email from Scott & White:   Sub: New Contract Request  \"Tax ID#: 811890349  RE: Network Denial  Dear Katherine  D Paterson  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 03/03/2021, SWHP and FirstCare regretfully declines to contract with Katherine  D Paterson this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.   Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-07 12:37:49', '2021-06-07 12:37:49'),
(12818, 3046, 20128, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:35:47', '2021-03-12 13:35:47'),
(12819, 3040, 20128, NULL, '2021-06-14 00:00:00.000', 'Not Eligible', 'We received the following Network Denial/Rejection email from Scott & White:   Sub: New Contract Request  \"Tax ID#: 811890349  RE: Network Denial  Dear Katherine  D Paterson  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 03/03/2021, SWHP and FirstCare regretfully declines to contract with Katherine  D Paterson this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.   Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-07 12:37:53', '2021-06-07 12:37:53'),
(12820, 3046, 20129, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:35:50', '2021-03-12 13:35:50'),
(12821, 3040, 20129, NULL, '2021-06-14 00:00:00.000', 'Not Eligible', 'We received the following Network Denial/Rejection email from Scott & White:   Sub: New Contract Request  \"Tax ID#: 811890349  RE: Network Denial  Dear Katherine  D Paterson  Thank you for your recent application.  Scott and White Health Plans (SWHP) and SHA, LLC dba FirstCare Health Plans (FirstCare) appreciates your interest in becoming a part of our network.  After reviewing your online application to contract submitted on 03/03/2021, SWHP and FirstCare regretfully declines to contract with Katherine  D Paterson this time. The determination was made based on our current network needs. However, we encourage you to reapply in 6 months; as those needs may change.   Thank you again for your interest in SWHP and FirstCare Health Plans.  Best Regards,  Scott and White Health Plans |SHA, LLC dba FirstCare Health Plans Network Development Department 1206 West Campus Dr. Temple, Texas 76502\"', NULL, NULL, '2021-06-07 12:37:57', '2021-06-07 12:37:57'),
(12822, 3046, 20130, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:37:49', '2021-03-12 13:37:49'),
(12823, 1006, 20130, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Request has been initiated to add provider to group contract via Superior website: \"Thank You For Your Request! Important to Note:  Prior to a new provider’s provision of services and receipt of claims reimbursement, program enrollment must be confirmed on requests for Superior Medicaid (STAR, STAR Health, STAR Kids and STAR+PLUS), CHIP and/or Long-Term Services and Supports (LTSS) programs.  Superior will notify you of acceptance or non-acceptance to our network no later than 90 days from receipt of a complete application for participation.  If additional information is required to process your request, a Superior representative will contact you soon.\"  Attached for reference.', NULL, NULL, '2021-05-05 12:16:33', '2021-05-05 12:16:33'),
(12824, 1006, 20130, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent following enrollment query @ AM.Austin@SuperiorHealthPlan.com & SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: Enrollment Query - CBUC/GWMC -  Superior Health/Ambetter  \"Hello,  I wanted to verify if the following group and providers were enrolled with Superior Healthplan & Ambetter under the mentioned addresses:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Katherine Paterson NPI# 1164776548  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Please get back to me as soon as you\'re able. Thank you. \"', NULL, NULL, '2021-06-09 09:49:19', '2021-06-09 09:49:19'),
(12825, 1006, 20130, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Received the following approval confirmation from AM.CorpusChristi@superiorhealthplan.com:  Sub: Approvals and Test Claims (Providers/Groups) - (GWMC) - (Cigna)  \"Good afternoon Brad  Hope all is well today  Here is the information you requested, I have included all the Providers in a SS with all the products associated with the TID#811890349  And I have also included a snip-it of the address associated with the group TID Have a great rest of the week   Veronica Botello Rocha Provider Relations Coordinator II Provider Relations Department Nueces, Harris & Jefferson SDAs cid:image002.jpg@01D0C3DA.F54AEF00 711 N. Carancahua Street, Suite 600 Corpus Christi, Texas 78401 Fax: (866) 683-5630 AM.CorpusChristi@superiorhealthplan.com| SuperiorHealthPlan.com Provider Relations Dept. 1-800-656-4817 Option 3\"  Approval confirmation is attached for reference.  ', NULL, NULL, '2021-06-29 14:09:54', '2021-06-29 14:09:54'),
(12826, 3046, 20131, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:37:50', '2021-03-12 13:37:50'),
(12827, 1006, 20131, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Request has been initiated to add provider to group contract via Superior website: \"Thank You For Your Request! Important to Note:  Prior to a new provider’s provision of services and receipt of claims reimbursement, program enrollment must be confirmed on requests for Superior Medicaid (STAR, STAR Health, STAR Kids and STAR+PLUS), CHIP and/or Long-Term Services and Supports (LTSS) programs.  Superior will notify you of acceptance or non-acceptance to our network no later than 90 days from receipt of a complete application for participation.  If additional information is required to process your request, a Superior representative will contact you soon.\"  Attached for reference. ', NULL, NULL, '2021-05-05 12:19:19', '2021-05-05 12:19:19'),
(12828, 1006, 20131, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent following enrollment query @ AM.Austin@SuperiorHealthPlan.com & SHP.NetworkDevelopment@superiorhealthplan.com:  Sub: Enrollment Query - CBUC/GWMC -  Superior Health/Ambetter  \"Hello,  I wanted to verify if the following group and providers were enrolled with Superior Healthplan & Ambetter under the mentioned addresses:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349  Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Katherine Paterson NPI# 1164776548  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Please get back to me as soon as you\'re able. Thank you. \"', NULL, NULL, '2021-06-09 09:49:15', '2021-06-09 09:49:15'),
(12829, 1006, 20131, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Received the following approval confirmation from AM.CorpusChristi@superiorhealthplan.com:  Sub: Approvals and Test Claims (Providers/Groups) - (GWMC) - (Cigna)  \"Good afternoon Brad  Hope all is well today  Here is the information you requested, I have included all the Providers in a SS with all the products associated with the TID#811890349  And I have also included a snip-it of the address associated with the group TID Have a great rest of the week   Veronica Botello Rocha Provider Relations Coordinator II Provider Relations Department Nueces, Harris & Jefferson SDAs cid:image002.jpg@01D0C3DA.F54AEF00 711 N. Carancahua Street, Suite 600 Corpus Christi, Texas 78401 Fax: (866) 683-5630 AM.CorpusChristi@superiorhealthplan.com| SuperiorHealthPlan.com Provider Relations Dept. 1-800-656-4817 Option 3\"  Approval confirmation is attached for reference. ', NULL, NULL, '2021-06-29 14:05:15', '2021-06-29 14:05:15'),
(12830, 3046, 20132, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:37:52', '2021-03-12 13:37:52'),
(12831, 1006, 20132, NULL, '2021-05-21 00:00:00.000', 'Initiated', 'Sent following email to Account Management - Corpus Christi AM.CorpusChristi@SuperiorHealthPlan.com:  Sub: Group Contract Request - CBUC - Superior Health  \"Hello,  I hope you\'re doing well, I wanted to know if you could please send us a copy of our groups executed contract, the information is as follows:  Group Name: Coastal Bend Urgent Care, LLC TIN# 81-1890349 NPI# 1427509264  Please get back to me as soon as you\'re able. Thank you. \"', NULL, NULL, '2021-05-05 12:06:31', '2021-05-05 12:06:31'),
(12832, 1006, 20132, NULL, '2021-05-25 00:00:00.000', 'Approved', 'Group is effective with Superior as of 12/01/2017, approval confirmation is attached for reference. ', NULL, NULL, '2021-05-18 09:36:32', '2021-05-18 09:36:32'),
(12833, 3046, 20135, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:38:50', '2021-03-12 13:38:50'),
(12834, 1006, 20135, NULL, '2021-06-15 00:00:00.000', 'Approved', 'The provider is enrolled with Texas Mutual Workers Comp, approval/location confirmation is attached for reference. ', NULL, NULL, '2021-06-08 15:03:04', '2021-06-08 15:03:04'),
(12835, 3046, 20136, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:38:51', '2021-03-12 13:38:51'),
(12836, 1006, 20136, NULL, '2021-06-15 00:00:00.000', 'Initiated', 'Sent provider addition request @ wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hello,  I hope you\'re doing well, we wanted to add the following provider under our group with the mentioned addresses: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264 Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324Secondary Address: 504A Houston Street, George West, TX 78022-3663 Provider Name: Katherine Paterson NPI# 1164776548  Please let me know what is required to proceed with this request, also our group is not showing up on the provider directory with either of the mentioned locations, please update that as well if possible.  Thank you. \"', NULL, NULL, '2021-06-08 15:12:02', '2021-06-08 15:12:02'),
(12837, 1006, 20136, NULL, '2021-07-05 00:00:00.000', 'In Process', 'We received the following response from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hi Brad,  Please see the attached credentialing documents that are required for providers to be added to our network.  Also, please see the screenshot from our directory. I’m not sure how you were searching for the group in our directory but per the credentialing documents, the locations have been listed as Beeville Medical Center and George West Medical Clinic in our directory since January 2021. (By clicking on the “advanced search” option, you can search by the group TIN and pull up all providers associated with that TIN.)  Feel free to contact me with any questions.  Thank you,   Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"  Forms were filled out and sent. Attached in providers task for reference.', NULL, NULL, '2021-06-28 17:12:20', '2021-06-28 17:12:20'),
(12838, 1006, 20136, NULL, '2021-08-05 00:00:00.000', 'In Process', 'We received the following update from WorkWell TX Contracts wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp   \"Hi Brad,  Please see the attached welcome letter and quick reference sheet. Feel free to contact me with any questions.\"  Replied with:  \"Hello DeeDee,   I appreciate the update, can you please let me know what is required to add the provider under our secondary address as well? Also, she is not showing up on the WorkWell provider directory. Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-07-29 12:31:59', '2021-07-29 12:31:59'),
(12839, 1006, 20136, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following reply from wwtxcontracts@texasmutual.com:  Sub: Provider Addition Request - CBUC/GWMC - Texas Mutual Workers Comp  \"Hi Brad,  In order to get a location added for a provider, we have to receive pages 6-7 of the TSCA with the provider’s practice site information listed.  As for the directory, it typically takes our vendor about three weeks to update the online directory with newly added providers and changes/ updates to provider records (i.e. adding/ removing practice sites, etc.)  Hope this helps!  Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"  Replied with:  \"Hello Dee Dee,   I appreciate the update, would this work out?  Thank you. \"', NULL, NULL, '2021-08-02 16:56:25', '2021-08-02 16:56:25'),
(12840, 1006, 20136, NULL, '2021-08-10 00:00:00.000', 'In Process', 'Received update from wwtxcontracts@texasmutual.com:  \"Good morning,  Yes, those are the correct pages. She should be listed in our directory at both locations within the next few weeks.  Thank you,  Dee Dee Johnson Provider Relations Consultant Texas Mutual Insurance Company Ph: 512.224.7357 Fax: 512.224.8826 wwtxcontracts@texasmutual.com \"', NULL, NULL, '2021-08-03 09:22:07', '2021-08-03 09:22:07'),
(12841, 11056, 20136, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : wwtxcontracts@texasmutual.com  Sub : Enrollment Status Query - CBUC/GWMC - Texas Mutual Workers Comp  Good evening!  Hope all is well. Please inform me whenever the secondary location & provider mentioned below enrolled and listed under the Tax I.D. Please provide me with the latest updates soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  If you require any further information or documents please let me know. Waiting for your response.  Thank you! Have a great week ahead!', NULL, NULL, '2021-08-18 16:04:53', '2021-08-18 16:04:53'),
(12842, 11056, 20136, NULL, '2021-09-10 00:00:00.000', 'Approved', 'Email received from : wwtxcontracts@texasmutual.com  Sub : Enrollment Status Query - CBUC/GWMC - Texas Mutual Workers Comp  Hi Ahmed,   The provider is listed at both locations in our directory (see below). In the future, please utilize our online directory (https://www.viiad.com/tmi/public/main/Home) to check provider’s network status and practice locations. (The “advanced search” option allows you to search by TIN.)  Eff date is : 08/01/2021  Please see the attachment.', NULL, NULL, '2021-09-03 11:21:56', '2021-09-03 11:21:56'),
(12843, 3046, 20137, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:38:55', '2021-03-12 13:38:55'),
(12844, 1006, 20137, NULL, '2021-06-15 00:00:00.000', 'Approved', 'The provider is enrolled with Texas Mutual Workers Comp, approval/location confirmation is attached for reference. ', NULL, NULL, '2021-06-08 15:04:35', '2021-06-08 15:04:35'),
(12845, 3040, 20144, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:42:12', '2021-03-12 13:42:12'),
(12846, 3040, 20144, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:07:43', '2021-03-25 12:07:43'),
(12847, 3040, 20144, NULL, '2021-04-29 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,  I just wanted to follow up regarding my previous email.   Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-22 15:49:15', '2021-04-22 15:49:15'),
(12848, 3040, 20144, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart |  Greetings,  I am trying to find out the type of contract. Can you please send me the copy of the contract?. Below are the mentioned details:  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-06-01 15:51:47', '2021-06-01 15:51:47'),
(12849, 3040, 20144, NULL, '2021-06-28 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com, MDIPR@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. I wanted to find the type of contract for the below mentioned group. Can you please check and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-06-21 09:18:59', '2021-06-21 09:18:59'),
(12850, 3040, 20144, NULL, '2021-06-29 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Hi,  Our system has been updated as requested.  * The locations below have been added.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 82294)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-06-22 08:32:41', '2021-06-22 08:32:41'),
(12851, 3040, 20145, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:43:31', '2021-03-12 13:43:31'),
(12852, 3040, 20145, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:08:04', '2021-03-25 12:08:04'),
(12853, 3040, 20145, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:07:04', '2021-04-14 13:07:04'),
(12854, 3040, 20145, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:32:17', '2021-05-28 10:32:17'),
(12855, 3040, 20145, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:02:30', '2021-06-16 14:02:30'),
(12856, 3040, 20145, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:07', '2021-07-05 10:59:07'),
(12857, 3040, 20145, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart. Please see attachment ', NULL, NULL, '2021-07-05 11:14:17', '2021-07-05 11:14:17'),
(12858, 3040, 20146, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:43:49', '2021-03-12 13:43:49'),
(12859, 3040, 20146, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:19:07', '2021-03-25 12:19:07'),
(12860, 3040, 20146, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:06:14', '2021-04-14 13:06:14'),
(12861, 3040, 20146, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:32:41', '2021-05-28 10:32:41'),
(12862, 3040, 20146, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:02:59', '2021-06-16 14:02:59'),
(12863, 3040, 20146, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:16', '2021-07-05 10:59:16'),
(12864, 3040, 20146, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled with Health Smart. Please see attachment ', NULL, NULL, '2021-07-05 11:33:36', '2021-07-05 11:33:36'),
(12865, 3040, 20147, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:44:13', '2021-03-12 13:44:13'),
(12866, 3040, 20147, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:31:17', '2021-03-25 12:31:17'),
(12867, 3040, 20147, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:07:50', '2021-04-14 13:07:50'),
(12868, 3040, 20147, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:32:45', '2021-05-28 10:32:45'),
(12869, 3040, 20147, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:03:55', '2021-06-16 14:03:55'),
(12870, 3040, 20147, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:32', '2021-07-05 10:59:32');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12871, 3040, 20147, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart. Please see attachment. ', NULL, NULL, '2021-07-05 11:52:44', '2021-07-05 11:52:44'),
(12872, 3046, 20148, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:44:27', '2021-03-12 13:44:27'),
(12873, 3040, 20148, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Tricare ||  Hello Katherine,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Tricare for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:55:53', '2021-06-07 12:55:53'),
(12874, 1006, 20148, NULL, '2021-07-02 00:00:00.000', 'In Process', 'Sent f/u email @ Katherine Moten KMoten4@humana.com & Yvonne Wyatt ywyatt@humana.com:  Sub: Enrollment Status - CBUC/GWMC - Tricare  \"Hello,   I hope you\'re doing well, I wanted to verify if the following group and providers were enrolled with Tricare or not? If not, please let me know what is required to get them enrolled. The information is as follows:   Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-25 09:59:51', '2021-06-25 09:59:51'),
(12875, 1006, 20148, NULL, '2021-07-21 00:00:00.000', 'In Process', 'We received the following response from Yvonne:  \"Good Morning Brad,     Costal Bend Urgent Care address location is not in my area.  Katherine Moten is the TRICARE Liaison for Beeville and George West Texas. The street address happened to have a street name of Houston.  Katherine can assist you with any additional questions. You do not need to include me on the emails for her area.     I work Houston ,Galveston and the surrounding areas of these cities.        Here is the status: We show the tax id as network. The current status for each provider are listed below. You can check status on a provider by creating a log in on the provider Portal or search online under find care. Both can be found on the humanamilitary.com website.     Provider Name: Flynn, Mercedita N- we show has been added to both address locations. Provider NPI# 1619166188  Provider Name: Katherine Paterson- we show this provider is not affiliated to this group tax id you need to complete the spreadsheet to add this provider to this tax id. Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M- we show has been added to both address locations Provider NPI# 1720455835\"  Tried calling Katherine but no one picked up, left VM and resent f/u email @ :  \"Hello Katherine,   I hope you\'re doing well, please get back to me on this as soon as you\'re able.  Thanks. \"', NULL, NULL, '2021-07-14 17:13:23', '2021-07-14 17:13:23'),
(12876, 1006, 20148, NULL, '2021-08-02 00:00:00.000', 'Not Eligible', 'The provider is no longer a part of the group as per Ryan. ', NULL, NULL, '2021-07-26 09:01:20', '2021-07-26 09:01:20'),
(12877, 3046, 20149, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:44:28', '2021-03-12 13:44:28'),
(12878, 3040, 20149, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Tricare ||  Hello Katherine,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Tricare for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:55:57', '2021-06-07 12:55:57'),
(12879, 1006, 20149, NULL, '2021-07-02 00:00:00.000', 'In Process', 'Sent f/u email @ Katherine Moten KMoten4@humana.com & Yvonne Wyatt ywyatt@humana.com:  Sub: Enrollment Status - CBUC/GWMC - Tricare  \"Hello,   I hope you\'re doing well, I wanted to verify if the following group and providers were enrolled with Tricare or not? If not, please let me know what is required to get them enrolled. The information is as follows:   Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-25 09:59:47', '2021-06-25 09:59:47'),
(12880, 1006, 20149, NULL, '2021-07-21 00:00:00.000', 'In Process', 'We received the following response from Yvonne:  \"Good Morning Brad,     Costal Bend Urgent Care address location is not in my area.  Katherine Moten is the TRICARE Liaison for Beeville and George West Texas. The street address happened to have a street name of Houston.  Katherine can assist you with any additional questions. You do not need to include me on the emails for her area.     I work Houston ,Galveston and the surrounding areas of these cities.        Here is the status: We show the tax id as network. The current status for each provider are listed below. You can check status on a provider by creating a log in on the provider Portal or search online under find care. Both can be found on the humanamilitary.com website.     Provider Name: Flynn, Mercedita N- we show has been added to both address locations. Provider NPI# 1619166188  Provider Name: Katherine Paterson- we show this provider is not affiliated to this group tax id you need to complete the spreadsheet to add this provider to this tax id. Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M- we show has been added to both address locations Provider NPI# 1720455835\"  Tried calling Katherine but no one picked up, left VM and resent f/u email @ :  \"Hello Katherine,   I hope you\'re doing well, please get back to me on this as soon as you\'re able.  Thanks. \"', NULL, NULL, '2021-07-14 17:13:17', '2021-07-14 17:13:17'),
(12881, 11056, 20149, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : 	ywyatt@humana.com, & KMoten4@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good evening!  Hope all is well. I want to inquire about the spreadsheet to affiliate the provider Katherine Paterson to this group tax id, which you were going to provide in the month of July but haven\'t yet. Please provide it soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  If you need any documents or information regarding this feel free to contact me.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 14:50:03', '2021-08-18 14:50:03'),
(12882, 11056, 20149, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good morning Yvonne!  Hope this email finds you well. Thank you so much for your prompt response and submission of request to Provider network to display Katherine Paterson as network under the Beeville, Texas location. Could you please update me with the latest enrollment status of the below mentioned providers ?  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you have any questions or concerns feel free to reach out to me. Waiting to hear back from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 11:00:27', '2021-08-24 11:00:27'),
(12883, 11056, 20149, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email received from : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good Morning Ahmed,    I have submitted a request to Provider network to display Katherine Paterson as network under the Beeville, Texas location.        Thanks,  Yvonne W. Wyatt,  Humana Military  TRICARE Community Liaison II  Houston/Galveston  502-318-5409 Telephone  502-322-8018 Fax  ywyatt@humana.com     https://www.humanamilitary.com/coronavirus/provider     https://infocenter.humana-military.com/provider/service/Account/Login     Certification takes 90 days, and I do not have visual access to check the status. To check the status on a Tricare Certification applications, Please call WPS at  800-444-5445 and ask to speak to the Certfication Unit.     Certification applications forms please visit: https://www.humanamilitary.com/provider/education-and-resources/quick-access/forms Certification Fax: 608-221-7535  Provider Handbook: http://apps.humana.com/marketing/documents.asp?file=3262194', NULL, NULL, '2021-09-02 10:19:03', '2021-09-02 10:19:03'),
(12884, 11056, 20149, NULL, '2021-09-27 00:00:00.000', 'In Process', 'Email received from : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon Ahmed,  I am doing well, thanks  This tax id do not appear in my area. Katherine can assist you with your questions.   Thanks, Yvonne  Emailed at KMoten4@humana.com to get updates.', NULL, NULL, '2021-09-20 13:14:13', '2021-09-20 13:14:13'),
(12885, 11056, 20149, NULL, '2021-09-27 00:00:00.000', 'In Process', 'I have words with Jada H & Rheshonda at 18004445445. Both advised me to fax the form for adding the secondary location and the form has been faxed at 608-221-7535  Mercedita - is credentialed and in network  Ref code : 13844672   Please see the attachment.', NULL, NULL, '2021-09-20 14:22:39', '2021-09-20 14:22:39'),
(12886, 11056, 20149, NULL, '2021-10-07 00:00:00.000', 'In Process', 'Email received from : jtrenz@humana.com & ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good Morning  Ahmed,     Katherine, has taken another position.  This address location do not appear in my area. I will assist you with this question but any additional questions please reach out to Jacqueline Trenz. I have include her on this email.  You do not need to include me on the emails for this area    Provider Details: Provider Name: Flynn, Mercedita N  Provider NPI# 1619166188 - Show affiliated with this group tax id but is not display on the portal a request was submitted to update. Allow up to five business days to process.   Provider Name: Katherine Paterson- Show affiliated with this group tax id and is displayed  Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811 - Do not appear in our system as TRICARE certified. Below is the link to the certification application for you to complete and fax to WPS.', NULL, NULL, '2021-09-30 15:51:44', '2021-09-30 15:51:44'),
(12887, 11056, 20149, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare   Good afternoon!  Hope all is well with you. Please assist with the below at your earliest opportunity.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI & Queries Katherine Paterson	1164776548 : Please provide eff date & Please update the main                           location with proper address on your director  Mercedita Flynn	1619166188 : Latest updates on this application Monica Gonzalez	1871132811 : We have faxed the certification and credentialing                                      application to Tricare.  If you have any questions or require additional information or documents please don\'t hesitate in contacting me. Please see the attachment.  Thank you! Have a great day!', NULL, NULL, '2021-10-07 16:15:31', '2021-10-07 16:15:31'),
(12888, 11056, 20149, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email received from : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Please allow 90 days for processing of Ms. Gonzalez.  Application was faxed 9/20/2021.      Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-10-14 16:04:56', '2021-10-14 16:04:56'),
(12889, 11056, 20149, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email sent to : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Hello Jacqueline!  Hope you are doing great. Please help me out with the issue mentioned below:  Katherine Paterson - The main location is not appearing in your directory.  Mercedita Flynn - The secondary location is not appearing in your directory.  Please also see the attachments related to this. Kindly sort this out for me as soon as possible.  Thank you! Have a great weekend!', NULL, NULL, '2021-10-22 10:35:21', '2021-10-22 10:35:21'),
(12890, 11056, 20149, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from: jtrenz@humana.com  Sub:  Enrollment Status Updates - CBUC/GWMC - Tricare   Good morning,     The correct locations are showing up in my systems, so I have to send this the my provider administration team for a review.  Please email  a copy of the W-9 for the group so I can send my request.   Have provided them with their demands.', NULL, NULL, '2021-11-09 15:47:13', '2021-11-09 15:47:13'),
(12891, 11056, 20149, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from:  ywyatt@humana.com  Sub: Enrollment Status Updates - CBUC/GWMC - Tricare   Good afternoon Ahmed,     You can check the status and effective dates on a provider by creating a log-in on the Provide Portal using the links listed below. This address location is not in my area. You do not need to include me on the email for Coastal Bend unless there is a location in Houston Texas.     https://infocenter.humana-military.com/provider/service/Account/Login  Katherine Paterson is listed as network the effective date is listed on the Provider Portal    Mercedita Flynn is listed as network the effective date is listed on the Provider Portal  Monica Gonzalez- certification faxed to WPS can take up to 120 days to process. WPS will send you a letter once the application is complete. I do not have access to WPS system to give you the status. You can call 1800 444 5445 and ask to speak to the certification unit to check status.', NULL, NULL, '2021-11-24 12:43:34', '2021-11-24 12:43:34'),
(12892, 11056, 20149, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email sent to:  JTRENZ@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon Jacqueline!  Hope this email finds you well. Any update on the location listing in the provider directory? Have the locations been updated?  For Katherine : 301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324  For Mercedita : 504A Houston Street, George West , TX 78022-3663  Take Care! Have a wonderful week ahead!', NULL, NULL, '2021-12-10 13:04:27', '2021-12-10 13:04:27'),
(12893, 11056, 20149, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: JTRENZ@humana.com  Sub: Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon!  Hope this email finds you well. Please update me with the certification & credentialing process of the below-mentioned provider at your earliest convenience.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663 Provider Name	NPI Monica Gonzalez  	1871132811   If you require any further information or documents please let me know.  Thank you!', NULL, NULL, '2021-12-17 17:54:00', '2021-12-17 17:54:00'),
(12894, 11056, 20149, NULL, '2021-12-29 00:00:00.000', 'Approved', 'Email received from: jtrenz@humana.com  Sub: Enrollment Query - CBUC & GWMC - Tricare   M Flynn, Provider & Group is in-network and shows as affiliated with TIN 81-1890349 since 12/30/2016 at 301 S Hillside Dr, Suite 4, Beeville Tx 78102  Mercedita Flynn – No letter is available. The effective date is listed in the prior email.  Effective date: 12/30/2016  Please see the attachment.', NULL, NULL, '2021-12-22 13:04:59', '2021-12-22 13:04:59'),
(12895, 3040, 20150, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:44:28', '2021-03-12 13:44:28'),
(12896, 3040, 20150, NULL, '2021-04-01 00:00:00.000', 'Approved', 'Provider enrolled in Health smart.   Please see attachment.   ', NULL, NULL, '2021-03-25 12:34:49', '2021-03-25 12:34:49'),
(12897, 3040, 20151, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:44:50', '2021-03-12 13:44:50'),
(12898, 3040, 20151, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:01:08', '2021-03-25 13:01:08'),
(12899, 3040, 20151, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:11', '2021-04-05 09:00:11'),
(12900, 3040, 20151, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:04', '2021-04-12 10:49:04'),
(12901, 3040, 20151, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:38:31', '2021-05-28 09:38:31'),
(12902, 3040, 20151, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:21', '2021-06-16 14:36:21'),
(12903, 3040, 20151, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:09:48', '2021-07-05 12:09:48'),
(12904, 3040, 20152, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:45:06', '2021-03-12 13:45:06'),
(12905, 3040, 20152, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:53:06', '2021-03-25 12:53:06'),
(12906, 3040, 20152, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:15', '2021-04-05 09:00:15'),
(12907, 3040, 20152, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:20', '2021-04-12 10:49:20'),
(12908, 3040, 20152, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:38:36', '2021-05-28 09:38:36'),
(12909, 1005, 20152, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'The provider Moses Campos is no longer with Valley Med Urgent Care', NULL, NULL, '2021-06-01 14:38:30', '2021-06-01 14:38:30'),
(12910, 3040, 20153, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:45:23', '2021-03-12 13:45:23'),
(12911, 3040, 20153, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:37', '2021-03-25 13:00:37'),
(12912, 3040, 20153, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:13', '2021-04-05 09:00:13'),
(12913, 3040, 20153, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form for Deborah Potter. I updated all the information in CAQH that was requested in your previous email.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you.', NULL, NULL, '2021-04-12 10:52:09', '2021-04-12 10:52:09'),
(12914, 3040, 20153, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  2. We are returning your application due to missing information listed below.  Provider Name	Missing Information DEBORAH POTTER, NP * SSN # * Current state license * Current certificate of Insurance * Explain Work History * Explain Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Credentialing Application form / State Replica * CAQH is not Updated', NULL, NULL, '2021-04-12 10:52:23', '2021-04-12 10:52:23'),
(12915, 3040, 20153, NULL, '2021-04-26 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject:  Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Thank you for your submission. The application has been forwarded to credentialing. Please follow up in 30 days for a status.  * Potter, Deborah NP. ', NULL, NULL, '2021-04-19 07:11:26', '2021-04-19 07:11:26'),
(12916, 3040, 20153, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:38:40', '2021-05-28 09:38:40'),
(12917, 3040, 20153, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:36', '2021-06-16 14:36:36'),
(12918, 3040, 20153, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you  ', NULL, NULL, '2021-07-05 13:17:10', '2021-07-05 13:17:10'),
(12919, 3040, 20153, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart || Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thanks ', NULL, NULL, '2021-07-23 14:03:15', '2021-07-23 14:03:15'),
(12920, 3040, 20153, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thank you ', NULL, NULL, '2021-08-30 14:52:26', '2021-08-30 14:52:26'),
(12921, 10057, 20153, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Providers Application – Health Smart  Good Evening,  Hope this email finds you well. I wanted to know the enrollment status for the below mentioned provider in our group Valley Med Urgent Care PLLC under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631  Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Luyando, Mariana	1700960556 Hernandez, Juan	1225617558 Potter, Deborah	1861914053  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-14 16:09:43', '2021-10-14 16:09:43'),
(12922, 10057, 20153, NULL, '2021-11-12 00:00:00.000', 'Approved', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Providers Application – Health Smart  Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Juan A Hernandez, PA  08/01/2021   Deborah Potter, NP  06/01/2021   02- We are returning your application due to missing information listed below.  Provider Name   Missing Information   LUYANDO, MARIANA PA   Current certificate of Insurance.   Please review the attached Application Review Form and forward the missing information within the next 5 days. Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-11-05 13:50:01', '2021-11-05 13:50:01'),
(12923, 3040, 20154, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:45:38', '2021-03-12 13:45:38'),
(12924, 3040, 20154, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:53', '2021-03-25 13:00:53'),
(12925, 3040, 20154, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:06', '2021-04-05 09:00:06'),
(12926, 3040, 20154, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:34', '2021-04-12 10:49:34'),
(12927, 3040, 20154, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:38:45', '2021-05-28 09:38:45'),
(12928, 3040, 20154, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:50', '2021-06-16 14:36:50'),
(12929, 3040, 20154, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:10:59', '2021-07-05 12:10:59'),
(12930, 3040, 20155, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:47:39', '2021-03-12 13:47:39'),
(12931, 3040, 20155, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:27:05', '2021-03-25 12:27:05'),
(12932, 3040, 20155, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:10:26', '2021-04-14 13:10:26'),
(12933, 3040, 20155, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:37', '2021-05-28 10:33:37');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12934, 3040, 20155, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:03:24', '2021-06-16 14:03:24'),
(12935, 3040, 20155, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:28', '2021-07-05 10:59:28'),
(12936, 3040, 20155, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Re: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below locations for the below mentioned provider in Health smart in our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thanks ', NULL, NULL, '2021-07-05 11:59:55', '2021-07-05 11:59:55'),
(12937, 3040, 20155, NULL, '2021-07-30 00:00:00.000', 'Approved', 'Provider is participating with Health Smart. Please see attachment. ', NULL, NULL, '2021-07-23 14:19:31', '2021-07-23 14:19:31'),
(12938, 3040, 20156, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:47:59', '2021-03-12 13:47:59'),
(12939, 3040, 20156, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:31:12', '2021-03-25 12:31:12'),
(12940, 3040, 20156, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:08:03', '2021-04-14 13:08:03'),
(12941, 3040, 20156, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:41', '2021-05-28 10:33:41'),
(12942, 3040, 20156, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:03:48', '2021-06-16 14:03:48'),
(12943, 3040, 20156, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 11:01:28', '2021-07-05 11:01:28'),
(12944, 3040, 20156, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart. Please see attachment. ', NULL, NULL, '2021-07-05 11:52:52', '2021-07-05 11:52:52'),
(12945, 3040, 20157, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:48:18', '2021-03-12 13:48:18'),
(12946, 3040, 20157, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:34:10', '2021-03-25 12:34:10'),
(12947, 3040, 20157, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:07:27', '2021-04-14 13:07:27'),
(12948, 3040, 20157, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:45', '2021-05-28 10:33:45'),
(12949, 3040, 20157, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:03:11', '2021-06-16 14:03:11'),
(12950, 3040, 20157, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:20', '2021-07-05 10:59:20'),
(12951, 3040, 20157, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health smart.   Please see attachment. ', NULL, NULL, '2021-07-05 11:34:59', '2021-07-05 11:34:59'),
(12952, 3040, 20158, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:48:34', '2021-03-12 13:48:34'),
(12953, 3040, 20158, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:39:25', '2021-03-25 12:39:25'),
(12954, 3040, 20158, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:05:08', '2021-04-14 13:05:08'),
(12955, 3040, 20158, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:50', '2021-05-28 10:33:50'),
(12956, 3040, 20158, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:02:15', '2021-06-16 14:02:15'),
(12957, 3040, 20158, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Provider is participating with Health Smart. Please see attachment. ', NULL, NULL, '2021-06-29 15:27:30', '2021-06-29 15:27:30'),
(12958, 3046, 20159, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:48:38', '2021-03-12 13:48:38'),
(12959, 3040, 20159, NULL, '2021-06-14 00:00:00.000', 'In Process', 'Email sent to: KMoten4@humana.com  Subject: Enroll Group & Providers || Coastal Bend Urgent Care & George West Medical Clinic || Group & Providers || Tricare ||  Hello Katherine,  Hope you are doing well. I wanted to enroll the below mentioned group and providers Tricare for our group under the below locations.   Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4 BEEVILLE , TX 78102-5324  Practice Name: George West Medical Clinic Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 504A Houston Street George West , TX 78022-3663  Provider 1: Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider 2:   Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider 3:   Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-06-07 12:56:01', '2021-06-07 12:56:01'),
(12960, 1006, 20159, NULL, '2021-07-02 00:00:00.000', 'In Process', 'Sent f/u email @ Katherine Moten KMoten4@humana.com & Yvonne Wyatt ywyatt@humana.com:  Sub: Enrollment Status - CBUC/GWMC - Tricare  \"Hello,   I hope you\'re doing well, I wanted to verify if the following group and providers were enrolled with Tricare or not? If not, please let me know what is required to get them enrolled. The information is as follows:   Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# 81-1890349 Practice NPI# 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, Beeville, TX 78102-5324 Secondary Practice Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M Provider NPI# 1720455835  Please get back to me as soon as possible.  Thank you!\"', NULL, NULL, '2021-06-25 09:59:43', '2021-06-25 09:59:43'),
(12961, 1006, 20159, NULL, '2021-07-21 00:00:00.000', 'In Process', 'We received the following response from Yvonne:  \"Good Morning Brad,     Costal Bend Urgent Care address location is not in my area.  Katherine Moten is the TRICARE Liaison for Beeville and George West Texas. The street address happened to have a street name of Houston.  Katherine can assist you with any additional questions. You do not need to include me on the emails for her area.     I work Houston ,Galveston and the surrounding areas of these cities.        Here is the status: We show the tax id as network. The current status for each provider are listed below. You can check status on a provider by creating a log in on the provider Portal or search online under find care. Both can be found on the humanamilitary.com website.     Provider Name: Flynn, Mercedita N- we show has been added to both address locations. Provider NPI# 1619166188  Provider Name: Katherine Paterson- we show this provider is not affiliated to this group tax id you need to complete the spreadsheet to add this provider to this tax id. Provider NPI# 1164776548  Provider Name: Tudor, Jennifer M- we show has been added to both address locations Provider NPI# 1720455835\"  Tried calling Katherine but no one picked up, left VM and resent f/u email @ :  \"Hello Katherine,   I hope you\'re doing well, please get back to me on this as soon as you\'re able.  Thanks. \"', NULL, NULL, '2021-07-14 17:13:08', '2021-07-14 17:13:08'),
(12962, 11056, 20159, NULL, '2021-08-26 00:00:00.000', 'In Process', 'Email sent to : 	ywyatt@humana.com, & KMoten4@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good evening!  Hope all is well. I want to inquire about the spreadsheet to affiliate the provider Katherine Paterson to this group tax id, which you were going to provide in the month of July but haven\'t yet. Please provide it soon.  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Katherine Paterson Provider NPI# 1164776548  If you need any documents or information regarding this feel free to contact me.  Thank you! Have a great day!', NULL, NULL, '2021-08-18 14:49:49', '2021-08-18 14:49:49'),
(12963, 11056, 20159, NULL, '2021-08-31 00:00:00.000', 'In Process', 'Email sent to : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good morning Yvonne!  Hope this email finds you well. Thank you so much for your prompt response and submission of request to Provider network to display Katherine Paterson as network under the Beeville, Texas location. Could you please update me with the latest enrollment status of the below mentioned providers ?  Practice Details: Practice Name: Coastal Bend Urgent Care, LLC Practice Tax ID# : 81-1890349 Practice NPI# : 1427509264 Practice Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Details: Provider Name: Flynn, Mercedita N Provider NPI# 1619166188  Provider Name: Katherine Paterson Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811  If you have any questions or concerns feel free to reach out to me. Waiting to hear back from you soon.  Thank you! Have a great day!', NULL, NULL, '2021-08-24 11:00:19', '2021-08-24 11:00:19'),
(12964, 11056, 20159, NULL, '2021-09-09 00:00:00.000', 'In Process', 'Email received from : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good Morning Ahmed,    I have submitted a request to Provider network to display Katherine Paterson as network under the Beeville, Texas location.        Thanks,  Yvonne W. Wyatt,  Humana Military  TRICARE Community Liaison II  Houston/Galveston  502-318-5409 Telephone  502-322-8018 Fax  ywyatt@humana.com     https://www.humanamilitary.com/coronavirus/provider     https://infocenter.humana-military.com/provider/service/Account/Login     Certification takes 90 days, and I do not have visual access to check the status. To check the status on a Tricare Certification applications, Please call WPS at  800-444-5445 and ask to speak to the Certfication Unit.     Certification applications forms please visit: https://www.humanamilitary.com/provider/education-and-resources/quick-access/forms Certification Fax: 608-221-7535  Provider Handbook: http://apps.humana.com/marketing/documents.asp?file=3262194', NULL, NULL, '2021-09-02 10:18:26', '2021-09-02 10:18:26'),
(12965, 11056, 20159, NULL, '2021-09-27 00:00:00.000', 'In Process', 'Email received from : ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon Ahmed,  I am doing well, thanks  This tax id do not appear in my area. Katherine can assist you with your questions.   Thanks, Yvonne  Emailed at KMoten4@humana.com to get updates.', NULL, NULL, '2021-09-20 13:14:07', '2021-09-20 13:14:07'),
(12966, 11056, 20159, NULL, '2021-09-27 00:00:00.000', 'In Process', 'I have words with Jada H & Rheshonda at 18004445445. Both advised me to fax the form for adding the secondary location and the form has been faxed at 608-221-7535  Mercedita - is credentialed and in network  Ref code : 13844672   Please see the attachment.', NULL, NULL, '2021-09-20 14:20:23', '2021-09-20 14:20:23'),
(12967, 11056, 20159, NULL, '2021-10-07 00:00:00.000', 'In Process', 'Email received from : jtrenz@humana.com & ywyatt@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good Morning  Ahmed,     Katherine, has taken another position.  This address location do not appear in my area. I will assist you with this question but any additional questions please reach out to Jacqueline Trenz. I have include her on this email.  You do not need to include me on the emails for this area    Provider Details: Provider Name: Flynn, Mercedita N  Provider NPI# 1619166188 - Show affiliated with this group tax id but is not display on the portal a request was submitted to update. Allow up to five business days to process.   Provider Name: Katherine Paterson- Show affiliated with this group tax id and is displayed  Provider NPI# 1164776548  Provider Name: Monica Gonzalez Provider NPI# 1871132811 - Do not appear in our system as TRICARE certified. Below is the link to the certification application for you to complete and fax to WPS.', NULL, NULL, '2021-09-30 15:51:35', '2021-09-30 15:51:35'),
(12968, 11056, 20159, NULL, '2021-10-14 00:00:00.000', 'In Process', 'Email sent to : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare   Good afternoon!  Hope all is well with you. Please assist with the below at your earliest opportunity.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324 Secondary Location	504A Houston Street, George West , TX 78022-3663 Provider Name	NPI & Queries Katherine Paterson	1164776548 : Please provide eff date & Please update the main                           location with proper address on your director  Mercedita Flynn	1619166188 : Latest updates on this application Monica Gonzalez	1871132811 : We have faxed the certification and credentialing                                      application to Tricare.  If you have any questions or require additional information or documents please don\'t hesitate in contacting me. Please see the attachment.  Thank you! Have a great day!', NULL, NULL, '2021-10-07 16:15:25', '2021-10-07 16:15:25'),
(12969, 11056, 20159, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email received from : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Please allow 90 days for processing of Ms. Gonzalez.  Application was faxed 9/20/2021.      Thank you,  Jacque Trenz Health System Consultant Humana Military TRICARE East', NULL, NULL, '2021-10-14 16:01:36', '2021-10-14 16:01:36'),
(12970, 11056, 20159, NULL, '2021-10-29 00:00:00.000', 'In Process', 'Email sent to : jtrenz@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Hello Jacqueline!  Hope you are doing great. Please help me out with the issue mentioned below:  Katherine Paterson - The main location is not appearing in your directory.  Mercedita Flynn - The secondary location is not appearing in your directory.  Please also see the attachments related to this. Kindly sort this out for me as soon as possible.  Thank you! Have a great weekend!', NULL, NULL, '2021-10-22 10:35:26', '2021-10-22 10:35:26'),
(12971, 11056, 20159, NULL, '2021-11-16 00:00:00.000', 'In Process', 'Email received from: jtrenz@humana.com  Sub:  Enrollment Status Updates - CBUC/GWMC - Tricare   Good morning,     The correct locations are showing up in my systems, so I have to send this the my provider administration team for a review.  Please email  a copy of the W-9 for the group so I can send my request.   Have provided them with their demands.', NULL, NULL, '2021-11-09 15:47:07', '2021-11-09 15:47:07'),
(12972, 11056, 20159, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Email received from:  ywyatt@humana.com  Sub: Enrollment Status Updates - CBUC/GWMC - Tricare   Good afternoon Ahmed,     You can check the status and effective dates on a provider by creating a log-in on the Provide Portal using the links listed below. This address location is not in my area. You do not need to include me on the email for Coastal Bend unless there is a location in Houston Texas.     https://infocenter.humana-military.com/provider/service/Account/Login  Katherine Paterson is listed as network the effective date is listed on the Provider Portal    Mercedita Flynn is listed as network the effective date is listed on the Provider Portal  Monica Gonzalez- certification faxed to WPS can take up to 120 days to process. WPS will send you a letter once the application is complete. I do not have access to WPS system to give you the status. You can call 1800 444 5445 and ask to speak to the certification unit to check status.', NULL, NULL, '2021-11-24 12:43:29', '2021-11-24 12:43:29'),
(12973, 11056, 20159, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email sent to:  JTRENZ@humana.com  Sub : Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon Jacqueline!  Hope this email finds you well. Any update on the location listing in the provider directory? Have the locations been updated?  For Katherine : 301 S HILLSIDE DR STE 4, BEEVILLE , TX 78102-5324  For Mercedita : 504A Houston Street, George West , TX 78022-3663  Take Care! Have a wonderful week ahead!', NULL, NULL, '2021-12-10 13:04:22', '2021-12-10 13:04:22'),
(12974, 11056, 20159, NULL, '2021-12-24 00:00:00.000', 'In Process', 'Email sent to: JTRENZ@humana.com  Sub: Enrollment Status Updates - CBUC/GWMC - Tricare  Good afternoon!  Hope this email finds you well. Please update me with the certification & credentialing process of the below-mentioned provider at your earliest convenience.  Group Name	Coastal Bend Urgent Care, LLC Tax ID	81-1890349 Group NPI	1427509264 Primary Location	301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Location	504A Houston Street, George West, TX 78022-3663 Provider Name	NPI Monica Gonzalez  	1871132811   If you require any further information or documents please let me know.  Thank you!', NULL, NULL, '2021-12-17 17:53:55', '2021-12-17 17:53:55'),
(12975, 11056, 20159, NULL, '2021-12-29 00:00:00.000', 'Approved', 'Email received from: jtrenz@humana.com  Sub: Enrollment Query - CBUC & GWMC - Tricare   M Flynn, Provider & Group is in-network and shows as affiliated with TIN 81-1890349 since 12/30/2016 at 301 S Hillside Dr, Suite 4, Beeville Tx 78102  Mercedita Flynn – No letter is available. The effective date is listed in the prior email.  Effective date: 12/30/2016  Please see the attachment. ', NULL, NULL, '2021-12-22 13:04:31', '2021-12-22 13:04:31'),
(12976, 3040, 20160, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:48:45', '2021-03-12 13:48:45'),
(12977, 3040, 20160, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:01:13', '2021-03-25 13:01:13'),
(12978, 3040, 20160, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:12', '2021-04-05 09:00:12'),
(12979, 3040, 20160, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:08', '2021-04-12 10:49:08'),
(12980, 3040, 20160, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:43:34', '2021-05-28 09:43:34'),
(12981, 3040, 20160, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:17', '2021-06-16 14:36:17');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(12982, 3040, 20160, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:09:53', '2021-07-05 12:09:53'),
(12983, 3040, 20161, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:48:59', '2021-03-12 13:48:59'),
(12984, 3040, 20161, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:18', '2021-03-25 13:00:18'),
(12985, 3040, 20161, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:16', '2021-04-05 09:00:16'),
(12986, 3040, 20161, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:24', '2021-04-12 10:49:24'),
(12987, 3040, 20161, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:43:38', '2021-05-28 09:43:38'),
(12988, 1005, 20161, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'The provider Moses Campos is no longer with Valley Med Urgent Care', NULL, NULL, '2021-06-01 14:38:16', '2021-06-01 14:38:16'),
(12989, 3040, 20162, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:49:11', '2021-03-12 13:49:11'),
(12990, 3040, 20162, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:44', '2021-03-25 13:00:44'),
(12991, 3040, 20162, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:13', '2021-04-05 09:00:13'),
(12992, 3040, 20162, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form for Deborah Potter. I updated all the information in CAQH that was requested in your previous email.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you.', NULL, NULL, '2021-04-12 10:52:33', '2021-04-12 10:52:33'),
(12993, 3040, 20162, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  2. We are returning your application due to missing information listed below.  Provider Name	Missing Information DEBORAH POTTER, NP * SSN # * Current state license * Current certificate of Insurance * Explain Work History * Explain Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Credentialing Application form / State Replica * CAQH is not Updated', NULL, NULL, '2021-04-12 10:53:12', '2021-04-12 10:53:12'),
(12994, 3040, 20162, NULL, '2021-04-26 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject:  Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Thank you for your submission. The application has been forwarded to credentialing. Please follow up in 30 days for a status.  * Potter, Deborah NP. ', NULL, NULL, '2021-04-19 07:11:30', '2021-04-19 07:11:30'),
(12995, 3040, 20162, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:43:41', '2021-05-28 09:43:41'),
(12996, 3040, 20162, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:31', '2021-06-16 14:36:31'),
(12997, 3040, 20162, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you  ', NULL, NULL, '2021-07-05 13:17:14', '2021-07-05 13:17:14'),
(12998, 3040, 20162, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart || Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thanks ', NULL, NULL, '2021-07-23 14:03:17', '2021-07-23 14:03:17'),
(12999, 3040, 20162, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thank you ', NULL, NULL, '2021-08-30 14:52:26', '2021-08-30 14:52:26'),
(13000, 10057, 20162, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Providers Application – Health Smart  Good Evening,  Hope this email finds you well. I wanted to know the enrollment status for the below mentioned provider in our group Valley Med Urgent Care PLLC under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631  Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Luyando, Mariana	1700960556 Hernandez, Juan	1225617558 Potter, Deborah	1861914053  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-14 16:09:29', '2021-10-14 16:09:29'),
(13001, 10057, 20162, NULL, '2021-11-12 00:00:00.000', 'Approved', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Providers Application – Health Smart  Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Juan A Hernandez, PA  08/01/2021   Deborah Potter, NP  06/01/2021   02- We are returning your application due to missing information listed below.  Provider Name   Missing Information   LUYANDO, MARIANA PA   Current certificate of Insurance.   Please review the attached Application Review Form and forward the missing information within the next 5 days. Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-11-05 13:49:47', '2021-11-05 13:49:47'),
(13002, 3040, 20163, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:49:22', '2021-03-12 13:49:22'),
(13003, 3040, 20163, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:58', '2021-03-25 13:00:58'),
(13004, 3040, 20163, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:08', '2021-04-05 09:00:08'),
(13005, 3040, 20163, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:38', '2021-04-12 10:49:38'),
(13006, 3040, 20163, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:43:45', '2021-05-28 09:43:45'),
(13007, 3040, 20163, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:45', '2021-06-16 14:36:45'),
(13008, 3040, 20163, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:10:10', '2021-07-05 12:10:10'),
(13009, 3046, 20164, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:49:49', '2021-03-12 13:49:49'),
(13010, 1006, 20164, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - CBUC - UHC  \"Hello,  I wanted to get an update regarding the enrollment status for the following providers under the mentioned group:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Provider Name: Katherine Paterson NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \'', NULL, NULL, '2021-06-04 14:59:34', '2021-06-04 14:59:34'),
(13011, 1006, 20164, NULL, '2021-06-16 00:00:00.000', 'Approved', 'The group is enrolled with UHC, executed contract is attached for reference. ', NULL, NULL, '2021-06-09 13:46:10', '2021-06-09 13:46:10'),
(13012, 3046, 20165, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:49:53', '2021-03-12 13:49:53'),
(13013, 1006, 20165, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - CBUC - UHC  \"Hello,  I wanted to get an update regarding the enrollment status for the following providers under the mentioned group:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Provider Name: Katherine Paterson NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \'', NULL, NULL, '2021-06-04 14:59:41', '2021-06-04 14:59:41'),
(13014, 1006, 20165, NULL, '2021-06-16 00:00:00.000', 'Approved', 'The provider is enrolled with CBUC, attached UHC roster for confirmation. ', NULL, NULL, '2021-06-09 13:45:03', '2021-06-09 13:45:03'),
(13015, 3040, 20166, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:49:55', '2021-03-12 13:49:55'),
(13016, 3040, 20166, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:07:41', '2021-03-25 12:07:41'),
(13017, 3040, 20166, NULL, '2021-04-29 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,  I just wanted to follow up regarding my previous email.   Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-04-22 15:49:10', '2021-04-22 15:49:10'),
(13018, 3040, 20166, NULL, '2021-06-08 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart |  Greetings,  I am trying to find out the type of contract. Can you please send me the copy of the contract?. Below are the mentioned details:  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thank you', NULL, NULL, '2021-06-01 15:51:52', '2021-06-01 15:51:52'),
(13019, 3040, 20166, NULL, '2021-06-28 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com, mdiprsupport@healthsmart.com, MDIPR@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. I wanted to find the type of contract for the below mentioned group. Can you please check and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-06-21 09:18:53', '2021-06-21 09:18:53'),
(13020, 3040, 20166, NULL, '2021-06-29 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Hi,  Our system has been updated as requested.  * The locations below have been added.  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to MDIPR@healthsmart.com  (Inventory Log ID : 82294)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-06-22 08:32:47', '2021-06-22 08:32:47'),
(13021, 3040, 20167, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:50:11', '2021-03-12 13:50:11'),
(13022, 3040, 20167, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:08:13', '2021-03-25 12:08:13'),
(13023, 3040, 20167, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:07:12', '2021-04-14 13:07:12'),
(13024, 3040, 20167, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:19', '2021-05-28 10:33:19'),
(13025, 3040, 20167, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:02:25', '2021-06-16 14:02:25'),
(13026, 3040, 20167, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:11', '2021-07-05 10:59:11'),
(13027, 3040, 20167, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart. Please see attachment ', NULL, NULL, '2021-07-05 11:14:02', '2021-07-05 11:14:02'),
(13028, 3046, 20168, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:50:11', '2021-03-12 13:50:11'),
(13029, 1006, 20168, NULL, '2021-06-11 00:00:00.000', 'In Process', 'Sent f/u email @ NMRT networkhelp@uhc.com:  Sub: Enrollment Status - CBUC - UHC  \"Hello,  I wanted to get an update regarding the enrollment status for the following providers under the mentioned group:  Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264TIN# 81-1890349Primary Address: 301 S HILLSIDE DR STE 4, BEEVILLE, TX 78102-5324 Secondary Address: 504A Houston Street, George West, TX 78022-3663  Provider Name: Mercedita Flynn NPI# 1619166188  Provider Name: Jennifer Tudor NPI# 1720455835  Provider Name: Katherine Paterson NPI# 1164776548  Please get back to me as soon as possible.  Thank you. \'', NULL, NULL, '2021-06-04 14:59:46', '2021-06-04 14:59:46'),
(13030, 1006, 20168, NULL, '2021-06-16 00:00:00.000', 'Approved', 'The provider is enrolled with CBUC, attached UHC roster for confirmation. ', NULL, NULL, '2021-06-09 13:39:01', '2021-06-09 13:39:01'),
(13031, 3040, 20169, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:50:30', '2021-03-12 13:50:30'),
(13032, 3040, 20169, NULL, '2021-04-01 00:00:00.000', 'Approved', 'Provider enrolled with Health Smart.   Please see attachment. ', NULL, NULL, '2021-03-25 12:18:20', '2021-03-25 12:18:20'),
(13033, 3040, 20170, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:50:41', '2021-03-12 13:50:41'),
(13034, 3040, 20170, NULL, '2021-04-01 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart.   Please see attachment ', NULL, NULL, '2021-03-25 12:25:18', '2021-03-25 12:25:18'),
(13035, 3040, 20171, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:50:54', '2021-03-12 13:50:54'),
(13036, 3040, 20171, NULL, '2021-04-01 00:00:00.000', 'Approved', 'Provider enrolled in Health Smart.   Please see attachment. ', NULL, NULL, '2021-03-25 12:28:19', '2021-03-25 12:28:19'),
(13037, 3040, 20172, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:51:10', '2021-03-12 13:51:10'),
(13038, 3040, 20172, NULL, '2021-04-01 00:00:00.000', 'Approved', 'Provider enrolled in Health smart.   Please see attachment. ', NULL, NULL, '2021-03-25 12:30:56', '2021-03-25 12:30:56'),
(13039, 3040, 20173, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:51:22', '2021-03-12 13:51:22'),
(13040, 3040, 20173, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:34:14', '2021-03-25 12:34:14'),
(13041, 3040, 20173, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:07:34', '2021-04-14 13:07:34'),
(13042, 3040, 20173, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:24', '2021-05-28 10:33:24'),
(13043, 3040, 20173, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:03:06', '2021-06-16 14:03:06'),
(13044, 3040, 20173, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Fw: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hi,  Please provide the listed below information.  * All practice location\'s phone and fax #  All communication, including requested documents should be sent to pr.south@healthsmart.com. Please do not submit to mdipr@healthsmart.com  (Inventory Log ID : 81973)  Thanks Healthsmart Provider Relations.', NULL, NULL, '2021-07-05 10:59:24', '2021-07-05 10:59:24'),
(13045, 3040, 20173, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Provider enrolled in Health smart.   Please see attachment. ', NULL, NULL, '2021-07-05 11:35:03', '2021-07-05 11:35:03'),
(13046, 3040, 20174, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:51:33', '2021-03-12 13:51:33'),
(13047, 3040, 20174, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Type of Contract || Valley Med Urgent Care PLLC ||Health Smart ||  Greetings,   Hope you are doing well. Can you please advise me the type of contract we have under the Tax ID# 81-5123542 and also verify me that below locations are updated in the contract. Would it be possible for you to send the provider roster if not at least send me the list of the providers coming up under the system.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 12:39:36', '2021-03-25 12:39:36');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(13048, 3040, 20174, NULL, '2021-04-21 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-04-14 13:05:13', '2021-04-14 13:05:13'),
(13049, 3040, 20174, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Greetings,  I wanted to add the below mentioned group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks   ', NULL, NULL, '2021-05-28 10:33:32', '2021-05-28 10:33:32'),
(13050, 3040, 20174, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject; Re: Additional Locations || Valley Med Urgent Care PLLC || Group & Providers || Health Smart ||  Hello,  Hope you are doing well. I wanted to add the below mentioned locations for our group and providers in Health smart for our group Valley Med Urgent Care PLLC under the below mentioned locations.    Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Escobar, Angiollet Solis Provider NPI# 1962917997 Effective Date: 07/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 2: Provider Name: Rodriguez, Cynthia Provider NPI# 1124282553 Effective Date: 02/01/2013 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 3: Provider Name: Naranjo, Diego Provider NPI# 1568929800 Effective Date: 03/01/2020 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Provider 4: Provider Name: Hernandez, Eder Francisco Provider NPI# 1386956852 Effective Date: 05/01/2018 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 5: Provider Name: Garcia, Homero Provider NPI# 1730564857 Effective Date: 02/01/2019 Additional Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496  Provider 6: Provider Name: Saavedra, Teresa Provider NPI# 1255676151 Effective Date: 08/01/2020 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 7: Provider Name: Lopez, Mayra Alejandra Provider NPI# 1265945125 Effective Date: 12/01/2019 Additional Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248   Additional Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Please get back to me as soon as you can get a chance. Waiting for your response.   Thank you   ', NULL, NULL, '2021-06-16 14:02:20', '2021-06-16 14:02:20'),
(13051, 3040, 20174, NULL, '2021-07-06 00:00:00.000', 'Approved', 'Provider is participating with Health Smart. Please see attachment. ', NULL, NULL, '2021-06-29 15:27:37', '2021-06-29 15:27:37'),
(13052, 3040, 20175, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:51:46', '2021-03-12 13:51:46'),
(13053, 3040, 20175, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:01:17', '2021-03-25 13:01:17'),
(13054, 3040, 20175, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:13', '2021-04-05 09:00:13'),
(13055, 3040, 20175, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:15', '2021-04-12 10:49:15'),
(13056, 3040, 20175, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:41:08', '2021-05-28 09:41:08'),
(13057, 3040, 20175, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:11', '2021-06-16 14:36:11'),
(13058, 3040, 20175, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:10:00', '2021-07-05 12:10:00'),
(13059, 3040, 20176, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:52:01', '2021-03-12 13:52:01'),
(13060, 3040, 20176, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:32', '2021-03-25 13:00:32'),
(13061, 3040, 20176, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:17', '2021-04-05 09:00:17'),
(13062, 3040, 20176, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:29', '2021-04-12 10:49:29'),
(13063, 3040, 20176, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:41:12', '2021-05-28 09:41:12'),
(13064, 1005, 20176, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'The provider Moses Campos is no longer with Valley Med Urgent Care', NULL, NULL, '2021-06-01 14:38:00', '2021-06-01 14:38:00'),
(13065, 3040, 20177, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:52:13', '2021-03-12 13:52:13'),
(13066, 3040, 20177, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:00:49', '2021-03-25 13:00:49'),
(13067, 3040, 20177, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:14', '2021-04-05 09:00:14'),
(13068, 3040, 20177, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com, pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form for Deborah Potter. I updated all the information in CAQH that was requested in your previous email.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you.', NULL, NULL, '2021-04-12 10:52:53', '2021-04-12 10:52:53'),
(13069, 3040, 20177, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  2. We are returning your application due to missing information listed below.  Provider Name	Missing Information DEBORAH POTTER, NP * SSN # * Current state license * Current certificate of Insurance * Explain Work History * Explain Employment * Current Release and Attestation date * ALL Disclosure Questions Answered * Credentialing Application form / State Replica * CAQH is not Updated', NULL, NULL, '2021-04-12 10:53:16', '2021-04-12 10:53:16'),
(13070, 3040, 20177, NULL, '2021-04-26 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject:  Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Thank you for your submission. The application has been forwarded to credentialing. Please follow up in 30 days for a status.  * Potter, Deborah NP. ', NULL, NULL, '2021-04-19 07:11:35', '2021-04-19 07:11:35'),
(13071, 3040, 20177, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:41:16', '2021-05-28 09:41:16'),
(13072, 3040, 20177, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:27', '2021-06-16 14:36:27'),
(13073, 3040, 20177, NULL, '2021-07-12 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you  ', NULL, NULL, '2021-07-05 13:17:20', '2021-07-05 13:17:20'),
(13074, 3040, 20177, NULL, '2021-07-30 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart || Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thanks ', NULL, NULL, '2021-07-23 14:03:18', '2021-07-23 14:03:18'),
(13075, 3040, 20177, NULL, '2021-09-06 00:00:00.000', 'In Process', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Hope you are doing well. Please advise the enrollment status for the below mentioned provider in our group under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Waiting for your reply.   Thank you ', NULL, NULL, '2021-08-30 14:52:24', '2021-08-30 14:52:24'),
(13076, 10057, 20177, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : pr.south@healthsmart.com  Sub : Providers Application – Health Smart  Good Evening,  Hope this email finds you well. I wanted to know the enrollment status for the below mentioned provider in our group Valley Med Urgent Care PLLC under the below locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631  Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Luyando, Mariana	1700960556 Hernandez, Juan	1225617558 Potter, Deborah	1861914053  Looking forward to hearing from you. Have a great day!  Thanks & Regards,', NULL, NULL, '2021-10-14 16:11:05', '2021-10-14 16:11:05'),
(13077, 10057, 20177, NULL, '2021-11-12 00:00:00.000', 'Approved', 'Email Received From : mdiprsupport@healthsmart.com  Sub : Providers Application – Health Smart  Hi,  01- Please see the following Providers with effective dates.  Provider Name   Effective Date   Juan A Hernandez, PA  08/01/2021   Deborah Potter, NP  06/01/2021   02- We are returning your application due to missing information listed below.  Provider Name   Missing Information   LUYANDO, MARIANA PA   Current certificate of Insurance.   Please review the attached Application Review Form and forward the missing information within the next 5 days. Alternatively, please update CAQH and advise once completed.  All communication, including requested documents should be sent to pr.south@healthSmart.com. Please do not submit to MDIPR@healthsmart.com  Thanks HealthSmart Provider Relations.', NULL, NULL, '2021-11-05 13:49:25', '2021-11-05 13:49:25'),
(13078, 3040, 20178, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:52:25', '2021-03-12 13:52:25'),
(13079, 3040, 20178, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Healthsmart for our group Valley Med Urgent Care PLLC in all three locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-25 13:01:03', '2021-03-25 13:01:03'),
(13080, 3040, 20178, NULL, '2021-04-12 00:00:00.000', 'In Process', 'Email sent to: MDIPR@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. Please find the attached CAQH access form along with the W9 for the above mentioned providers.  If you need any additional information please feel free to call or email me . Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-04-05 09:00:10', '2021-04-05 09:00:10'),
(13081, 3040, 20178, NULL, '2021-04-19 00:00:00.000', 'In Process', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  1. Thank you for your submission. The applications have been forwarded to credentialing for the following providers. Please follow up in 30 days for a status.  Providers Name ARTURO A LIRA, PA LARRY D WRIGHT , NP MOSES CAMPOS, PA', NULL, NULL, '2021-04-12 10:49:43', '2021-04-12 10:49:43'),
(13082, 3040, 20178, NULL, '2021-06-04 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Greetings,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned providers for our group Valley Med Urgent Care PLLC under the below locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Wright, Larry Donald Provider NPI#  1033769765  Provider 2: Provider Name: Campos, Moses Provider NPI#  1558680009  Provider 3: Provider Name: Potter, Deborah Provider NPI#  1861914053  Provider 4: Provider Name: Lira, Arturo Alejandro Provider NPI#  1245789502  Please get back to me as soon as you can get a chance.  Thanks   ', NULL, NULL, '2021-05-28 09:41:19', '2021-05-28 09:41:19'),
(13083, 3040, 20178, NULL, '2021-06-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hello,   Thank you so much for your response. I checked the provider on Health Smart provider directory but I couldn\'t find the below mentioned provider on directory. Can you please check and advise?   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Address: 101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166      Provider 1: Provider Name: Potter, Deborah Provider NPI#  1861914053  Please get back to me as soon as you can get a chance. Waiting to hear from you soon.  Thank you ', NULL, NULL, '2021-06-16 14:36:41', '2021-06-16 14:36:41'),
(13084, 3040, 20178, NULL, '2021-07-12 00:00:00.000', 'Approved', 'Email rcvd from: mdiprsupport@healthsmart.com  Subject; Need To Enroll Providers || Valley Med Urgent Care PLLC || Wright, Larry Donald, Moses Campos, Deborah Potter & Arturo A Lira || Health Smart ||  Hi,  Please see below providers effective date.  Providers Name  Effective Date  WRIGHT, LARRY D  06/01/2021  CAMPOS, MOSES  06/01/2021  LIRA JR, ARTURO A  06/01/2021  Potter, Deborah  06/01/2021', NULL, NULL, '2021-07-05 12:10:05', '2021-07-05 12:10:05'),
(13085, 3046, 20179, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:52:42', '2021-03-12 13:52:42'),
(13086, 1006, 20179, NULL, '2021-06-15 00:00:00.000', 'Not Eligible', 'The provider only works in CBUC main location, no need to enroll her in GWMC location as per our discussion with Ryan. ', NULL, NULL, '2021-06-08 16:54:37', '2021-06-08 16:54:37'),
(13087, 3046, 20180, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:52:45', '2021-03-12 13:52:45'),
(13088, 1006, 20180, NULL, '2021-06-15 00:00:00.000', 'Approved', 'The location is already added with UHC, location confirmation is attached for reference. ', NULL, NULL, '2021-06-08 16:55:19', '2021-06-08 16:55:19'),
(13089, 3040, 20181, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:55:53', '2021-03-12 13:55:53'),
(13090, 3040, 20181, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:13', '2021-06-01 14:32:13'),
(13091, 3040, 20181, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com   Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-07-20 14:04:10', '2021-07-20 14:04:10'),
(13092, 3040, 20181, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,  Please advise the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,   Thanks  ', NULL, NULL, '2021-07-28 14:32:45', '2021-07-28 14:32:45'),
(13093, 3040, 20181, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: [External] Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,   Hope you are doing well. I sent the emails which are mentioned on the letter of interest form but I couldn\'t get any reply from their side. Can you please check the status and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,  Thank you  ', NULL, NULL, '2021-08-17 09:37:13', '2021-08-17 09:37:13'),
(13094, 10057, 20181, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope you are doing well. I wanted to know the enrollment updated status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-10-14 11:12:44', '2021-10-14 11:12:44'),
(13095, 10057, 20181, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : JENNIFER.PEREZ@cigna.com, TXGQProviderRelations@healthspring.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Hernandez, Juan	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:55:53', '2021-11-15 17:55:53'),
(13096, 10057, 20181, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Can I get the latest update on the below mentioned request.  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:08:12', '2021-11-30 13:08:12'),
(13097, 10057, 20181, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you in good health. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan  Hernandez	1225617558 Jeniece K  Wert	1659919702 Larry  Wright	1033769765 Teresa  Saavedra	1255676151 Eder  Hernandez	1386956852 Homero  Garcia	1730564857 Deborah  Potter	1861914053 Diego  Naranjo	1568929800 Mayra  Lopez	1265945125  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-12-06 17:42:00', '2021-12-06 17:42:00'),
(13098, 10057, 20181, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hey,  I\'m writing this email to check the current status on the below mentioned request. This is my second reminder.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-12-13 12:47:01', '2021-12-13 12:47:01'),
(13099, 10057, 20181, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Received From : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Steve,  The last Letter of Interest that was submitted to Valley Organized Physicians/LVPA was in October of 2018. The LVPA Board of Directors determined that there was no network need and appropriate communication was provided via mail. If the group would like to be reconsidered, please fill out the attached LOI and we can make sure to review during our January 2022 Board of Directors meeting. I is going to be important that you list out all locations as well.  Please let me know if you have any other questions.  Thank you, Iliana', NULL, NULL, '2021-12-20 11:49:03', '2021-12-20 11:49:03'),
(13100, 10057, 20181, NULL, '2022-01-03 00:00:00.000', 'In Process', 'Email Sent To : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Thank you for reaching out. Please find the attached LOI for groups and providers.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan Hernandez	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125 Escobar, Angiollet	1962917997 Rodriguez, Cynthia	1124282553  Please revert back to me once you have the update. Have a great day!  Regards,', NULL, NULL, '2021-12-27 11:10:56', '2021-12-27 11:10:56'),
(13101, 20067, 20181, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Subject: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hello Good Morning,  Hope you are doing well. I want to know the enrollment status for the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan Hernandez	1225617558 Jeniece Wert	1659919702 Cynthia Rodriguez	1124282553 Deborah Potter	1861914053 Larry Wright	1033769765 Teresa Saavedra	1255676151 Diego Naranjo	1568929800 Eder Hernandez	1386956852 Homero Garcia	1730564857 Angiollet Escobar	1962917997 Mayra Lopez	1265945125   Thanks and Regards, Syed Ahad.  ', NULL, NULL, '2022-01-05 12:54:34', '2022-01-05 12:54:34'),
(13102, 20067, 20181, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hello Syed,     I emailed Steve Albert, but the email bounced back.     We will be meeting with our LVPA and HOPE Board of Directors the week of the  24th where we will be discussing your group. Please fill out 1 LOI for the group with all location listed.  Please email me with any questions that you may have.     Thank you.     Iliana', NULL, NULL, '2022-01-11 13:59:56', '2022-01-11 13:59:56'),
(13103, 20067, 20181, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:06:10', '2022-01-11 14:06:10'),
(13104, 20067, 20181, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Thank you for the updated LOI. I added all locations. We meet with our Board of Directors on January 24th. Will be InTouch. ', NULL, NULL, '2022-01-11 17:50:46', '2022-01-11 17:50:46'),
(13105, 20067, 20181, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Will follow-up next week because the meeting of Board of Directors will be on  24th January', NULL, NULL, '2022-01-18 11:02:51', '2022-01-18 11:02:51'),
(13106, 20067, 20181, NULL, '2022-02-04 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Good Evening! Hope this email finds you well. Any updates on the request?  Eagerly waiting to hear from you, Thanks and Regards,', NULL, NULL, '2022-01-28 17:56:56', '2022-01-28 17:56:56'),
(13107, 20067, 20181, NULL, '2022-02-11 00:00:00.000', 'Not Eligible', 'Email received from: dulce.lumbrera@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hi Syed,  Thank you for reaching out. Please see attached for a response to the letter of interest that was presented at the Board of Director meeting. Thank you', NULL, NULL, '2022-02-04 10:52:02', '2022-02-04 10:52:02'),
(13108, 3046, 20182, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:55:57', '2021-03-12 13:55:57'),
(13109, 3040, 20182, NULL, '2021-06-15 00:00:00.000', 'In Process', 'LOI sent it through fax @8594558650', NULL, NULL, '2021-06-08 17:28:46', '2021-06-08 17:28:46'),
(13110, 1006, 20182, NULL, '2021-06-16 00:00:00.000', 'Approved', 'The copy of the executed urgentcare contract has been received and is attached for reference in the main group tasks. Both the locations are added under the group. Ref# 6023635857', NULL, NULL, '2021-06-09 09:31:11', '2021-06-09 09:31:11'),
(13111, 3046, 20183, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:55:58', '2021-03-12 13:55:58'),
(13112, 1006, 20183, NULL, '2021-06-15 00:00:00.000', 'Not Eligible', 'The provider only works in CBUC main location, no need to enroll her in GWMC location as per our discussion with Ryan. ', NULL, NULL, '2021-06-08 16:57:07', '2021-06-08 16:57:07'),
(13113, 3040, 20184, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:56:07', '2021-03-12 13:56:07'),
(13114, 3040, 20184, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:17', '2021-06-01 14:32:17'),
(13115, 3040, 20184, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com   Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-07-20 14:04:11', '2021-07-20 14:04:11'),
(13116, 3040, 20184, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,  Please advise the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,   Thanks  ', NULL, NULL, '2021-07-28 14:32:46', '2021-07-28 14:32:46'),
(13117, 3040, 20184, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: [External] Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,   Hope you are doing well. I sent the emails which are mentioned on the letter of interest form but I couldn\'t get any reply from their side. Can you please check the status and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,  Thank you  ', NULL, NULL, '2021-08-17 09:37:12', '2021-08-17 09:37:12');
INSERT INTO `cm_credentialing_task_logs` (`id`, `user_id`, `credentialing_task_id`, `last_follow_up`, `next_follow_up`, `status`, `details`, `image`, `pdf`, `created_at`, `updated_at`) VALUES
(13118, 10057, 20184, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope you are doing well. I wanted to know the enrollment updated status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-10-14 11:12:37', '2021-10-14 11:12:37'),
(13119, 10057, 20184, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : JENNIFER.PEREZ@cigna.com, TXGQProviderRelations@healthspring.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Hernandez, Juan	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:59:54', '2021-11-15 17:59:54'),
(13120, 10057, 20184, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Can I get the latest update on the below mentioned request.  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:08:05', '2021-11-30 13:08:05'),
(13121, 10057, 20184, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you in good health. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan  Hernandez	1225617558 Jeniece K  Wert	1659919702 Larry  Wright	1033769765 Teresa  Saavedra	1255676151 Eder  Hernandez	1386956852 Homero  Garcia	1730564857 Deborah  Potter	1861914053 Diego  Naranjo	1568929800 Mayra  Lopez	1265945125  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-12-06 17:41:54', '2021-12-06 17:41:54'),
(13122, 10057, 20184, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hey,  I\'m writing this email to check the current status on the below mentioned request. This is my second reminder.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-12-13 12:46:55', '2021-12-13 12:46:55'),
(13123, 10057, 20184, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Received From : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Steve,  The last Letter of Interest that was submitted to Valley Organized Physicians/LVPA was in October of 2018. The LVPA Board of Directors determined that there was no network need and appropriate communication was provided via mail. If the group would like to be reconsidered, please fill out the attached LOI and we can make sure to review during our January 2022 Board of Directors meeting. I is going to be important that you list out all locations as well.  Please let me know if you have any other questions.  Thank you, Iliana', NULL, NULL, '2021-12-20 11:48:58', '2021-12-20 11:48:58'),
(13124, 10057, 20184, NULL, '2022-01-03 00:00:00.000', 'In Process', 'Email Sent To : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Thank you for reaching out. Please find the attached LOI for groups and providers.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan Hernandez	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125 Escobar, Angiollet	1962917997 Rodriguez, Cynthia	1124282553  Please revert back to me once you have the update. Have a great day!  Regards,', NULL, NULL, '2021-12-27 11:10:50', '2021-12-27 11:10:50'),
(13125, 20067, 20184, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Subject: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hello Good Morning,  Hope you are doing well. I want to know the enrollment status for the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan Hernandez	1225617558 Jeniece Wert	1659919702 Cynthia Rodriguez	1124282553 Deborah Potter	1861914053 Larry Wright	1033769765 Teresa Saavedra	1255676151 Diego Naranjo	1568929800 Eder Hernandez	1386956852 Homero Garcia	1730564857 Angiollet Escobar	1962917997 Mayra Lopez	1265945125   Thanks and Regards, Syed Ahad. ', NULL, NULL, '2022-01-05 12:48:24', '2022-01-05 12:48:24'),
(13126, 20067, 20184, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hello Syed,     I emailed Steve Albert, but the email bounced back.     We will be meeting with our LVPA and HOPE Board of Directors the week of the  24th where we will be discussing your group. Please fill out 1 LOI for the group with all location listed.  Please email me with any questions that you may have.     Thank you.     Iliana', NULL, NULL, '2022-01-11 13:59:34', '2022-01-11 13:59:34'),
(13127, 20067, 20184, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:05:34', '2022-01-11 14:05:34'),
(13128, 20067, 20184, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:06:02', '2022-01-11 14:06:02'),
(13129, 20067, 20184, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Thank you for the updated LOI. I added all locations. We meet with our Board of Directors on January 24th. Will be InTouch. ', NULL, NULL, '2022-01-11 17:50:39', '2022-01-11 17:50:39'),
(13130, 20067, 20184, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Will follow-up next week because the meeting of Board of Directors will be on  24th January', NULL, NULL, '2022-01-18 11:02:45', '2022-01-18 11:02:45'),
(13131, 20067, 20184, NULL, '2022-02-04 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Good Evening! Hope this email finds you well. Any updates on the request?  Eagerly waiting to hear from you, Thanks and Regards,', NULL, NULL, '2022-01-28 17:56:51', '2022-01-28 17:56:51'),
(13132, 20067, 20184, NULL, '2022-02-11 00:00:00.000', 'Not Eligible', 'Email received from: dulce.lumbrera@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hi Syed,  Thank you for reaching out. Please see attached for a response to the letter of interest that was presented at the Board of Director meeting. Thank you', NULL, NULL, '2022-02-04 10:51:46', '2022-02-04 10:51:46'),
(13133, 3040, 20185, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:56:19', '2021-03-12 13:56:19'),
(13134, 3040, 20185, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:20', '2021-06-01 14:32:20'),
(13135, 3040, 20185, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com   Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-07-20 14:04:11', '2021-07-20 14:04:11'),
(13136, 3040, 20185, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,  Please advise the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,   Thanks  ', NULL, NULL, '2021-07-28 14:32:45', '2021-07-28 14:32:45'),
(13137, 3040, 20185, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: [External] Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,   Hope you are doing well. I sent the emails which are mentioned on the letter of interest form but I couldn\'t get any reply from their side. Can you please check the status and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,  Thank you  ', NULL, NULL, '2021-08-17 09:37:12', '2021-08-17 09:37:12'),
(13138, 10057, 20185, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope you are doing well. I wanted to know the enrollment updated status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-10-14 11:12:29', '2021-10-14 11:12:29'),
(13139, 10057, 20185, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : JENNIFER.PEREZ@cigna.com, TXGQProviderRelations@healthspring.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Hernandez, Juan	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:53:54', '2021-11-15 17:53:54'),
(13140, 10057, 20185, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Can I get the latest update on the below mentioned request.  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:07:59', '2021-11-30 13:07:59'),
(13141, 10057, 20185, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you in good health. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan  Hernandez	1225617558 Jeniece K  Wert	1659919702 Larry  Wright	1033769765 Teresa  Saavedra	1255676151 Eder  Hernandez	1386956852 Homero  Garcia	1730564857 Deborah  Potter	1861914053 Diego  Naranjo	1568929800 Mayra  Lopez	1265945125  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-12-06 17:41:48', '2021-12-06 17:41:48'),
(13142, 10057, 20185, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hey,  I\'m writing this email to check the current status on the below mentioned request. This is my second reminder.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-12-13 12:46:49', '2021-12-13 12:46:49'),
(13143, 10057, 20185, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Received From : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Steve,  The last Letter of Interest that was submitted to Valley Organized Physicians/LVPA was in October of 2018. The LVPA Board of Directors determined that there was no network need and appropriate communication was provided via mail. If the group would like to be reconsidered, please fill out the attached LOI and we can make sure to review during our January 2022 Board of Directors meeting. I is going to be important that you list out all locations as well.  Please let me know if you have any other questions.  Thank you, Iliana', NULL, NULL, '2021-12-20 11:48:53', '2021-12-20 11:48:53'),
(13144, 10057, 20185, NULL, '2022-01-03 00:00:00.000', 'In Process', 'Email Sent To : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Thank you for reaching out. Please find the attached LOI for groups and providers.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan Hernandez	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125 Escobar, Angiollet	1962917997 Rodriguez, Cynthia	1124282553  Please revert back to me once you have the update. Have a great day!  Regards,', NULL, NULL, '2021-12-27 11:10:44', '2021-12-27 11:10:44'),
(13145, 20067, 20185, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Subject: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hello Good Morning,  Hope you are doing well. I want to know the enrollment status for the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan Hernandez	1225617558 Jeniece Wert	1659919702 Cynthia Rodriguez	1124282553 Deborah Potter	1861914053 Larry Wright	1033769765 Teresa Saavedra	1255676151 Diego Naranjo	1568929800 Eder Hernandez	1386956852 Homero Garcia	1730564857 Angiollet Escobar	1962917997 Mayra Lopez	1265945125   Thanks and Regards, Syed Ahad.  ', NULL, NULL, '2022-01-05 12:51:55', '2022-01-05 12:51:55'),
(13146, 20067, 20185, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hello Syed,     I emailed Steve Albert, but the email bounced back.     We will be meeting with our LVPA and HOPE Board of Directors the week of the  24th where we will be discussing your group. Please fill out 1 LOI for the group with all location listed.  Please email me with any questions that you may have.     Thank you.     Iliana', NULL, NULL, '2022-01-11 13:59:27', '2022-01-11 13:59:27'),
(13147, 20067, 20185, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:05:23', '2022-01-11 14:05:23'),
(13148, 20067, 20185, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Thank you for the updated LOI. I added all locations. We meet with our Board of Directors on January 24th. Will be InTouch. ', NULL, NULL, '2022-01-11 17:50:32', '2022-01-11 17:50:32'),
(13149, 20067, 20185, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Will follow-up next week because the meeting of Board of Directors will be on  24th January', NULL, NULL, '2022-01-18 11:02:38', '2022-01-18 11:02:38'),
(13150, 20067, 20185, NULL, '2022-02-04 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Good Evening! Hope this email finds you well. Any updates on the request?  Eagerly waiting to hear from you, Thanks and Regards,', NULL, NULL, '2022-01-28 17:56:45', '2022-01-28 17:56:45'),
(13151, 20067, 20185, NULL, '2022-02-08 00:00:00.000', 'Not Eligible', 'Email received from: dulce.lumbrera@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hi Syed,  Thank you for reaching out. Please see attached for a response to the letter of interest that was presented at the Board of Director meeting. Thank you!', NULL, NULL, '2022-02-01 15:21:57', '2022-02-01 15:21:57'),
(13152, 3040, 20186, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:56:32', '2021-03-12 13:56:32'),
(13153, 3040, 20186, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:23', '2021-06-01 14:32:23'),
(13154, 3040, 20186, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com   Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-07-20 14:04:12', '2021-07-20 14:04:12'),
(13155, 3040, 20186, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,  Please advise the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,   Thanks  ', NULL, NULL, '2021-07-28 14:32:44', '2021-07-28 14:32:44'),
(13156, 3040, 20186, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: [External] Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,   Hope you are doing well. I sent the emails which are mentioned on the letter of interest form but I couldn\'t get any reply from their side. Can you please check the status and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,  Thank you  ', NULL, NULL, '2021-08-17 09:37:12', '2021-08-17 09:37:12'),
(13157, 10057, 20186, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope you are doing well. I wanted to know the enrollment updated status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-10-14 11:12:17', '2021-10-14 11:12:17'),
(13158, 10057, 20186, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : JENNIFER.PEREZ@cigna.com, TXGQProviderRelations@healthspring.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Hernandez, Juan	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:53:13', '2021-11-15 17:53:13'),
(13159, 10057, 20186, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Can I get the latest update on the below mentioned request.  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:07:49', '2021-11-30 13:07:49'),
(13160, 10057, 20186, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you in good health. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan  Hernandez	1225617558 Jeniece K  Wert	1659919702 Larry  Wright	1033769765 Teresa  Saavedra	1255676151 Eder  Hernandez	1386956852 Homero  Garcia	1730564857 Deborah  Potter	1861914053 Diego  Naranjo	1568929800 Mayra  Lopez	1265945125  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-12-06 17:41:40', '2021-12-06 17:41:40'),
(13161, 10057, 20186, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hey,  I\'m writing this email to check the current status on the below mentioned request. This is my second reminder.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-12-13 12:46:43', '2021-12-13 12:46:43'),
(13162, 10057, 20186, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Received From : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Steve,  The last Letter of Interest that was submitted to Valley Organized Physicians/LVPA was in October of 2018. The LVPA Board of Directors determined that there was no network need and appropriate communication was provided via mail. If the group would like to be reconsidered, please fill out the attached LOI and we can make sure to review during our January 2022 Board of Directors meeting. I is going to be important that you list out all locations as well.  Please let me know if you have any other questions.  Thank you, Iliana', NULL, NULL, '2021-12-20 11:48:48', '2021-12-20 11:48:48'),
(13163, 10057, 20186, NULL, '2022-01-03 00:00:00.000', 'In Process', 'Email Sent To : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Thank you for reaching out. Please find the attached LOI for groups and providers.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan Hernandez	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125 Escobar, Angiollet	1962917997 Rodriguez, Cynthia	1124282553  Please revert back to me once you have the update. Have a great day!  Regards,', NULL, NULL, '2021-12-27 11:10:37', '2021-12-27 11:10:37'),
(13164, 20067, 20186, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Subject: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hello Good Morning,  Hope you are doing well. I want to know the enrollment status for the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan Hernandez	1225617558 Jeniece Wert	1659919702 Cynthia Rodriguez	1124282553 Deborah Potter	1861914053 Larry Wright	1033769765 Teresa Saavedra	1255676151 Diego Naranjo	1568929800 Eder Hernandez	1386956852 Homero Garcia	1730564857 Angiollet Escobar	1962917997 Mayra Lopez	1265945125   Thanks and Regards, Syed Ahad.  ', NULL, NULL, '2022-01-05 12:50:44', '2022-01-05 12:50:44'),
(13165, 20067, 20186, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hello Syed,     I emailed Steve Albert, but the email bounced back.     We will be meeting with our LVPA and HOPE Board of Directors the week of the  24th where we will be discussing your group. Please fill out 1 LOI for the group with all location listed.  Please email me with any questions that you may have.     Thank you.     Iliana', NULL, NULL, '2022-01-11 13:59:20', '2022-01-11 13:59:20'),
(13166, 20067, 20186, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:05:11', '2022-01-11 14:05:11'),
(13167, 20067, 20186, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Thank you for the updated LOI. I added all locations. We meet with our Board of Directors on January 24th. Will be InTouch. ', NULL, NULL, '2022-01-11 17:50:26', '2022-01-11 17:50:26'),
(13168, 20067, 20186, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Will follow-up next week because the meeting of Board of Directors will be on  24th January', NULL, NULL, '2022-01-18 11:02:32', '2022-01-18 11:02:32'),
(13169, 20067, 20186, NULL, '2022-02-04 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Good Evening! Hope this email finds you well. Any updates on the request?  Eagerly waiting to hear from you, Thanks and Regards,', NULL, NULL, '2022-01-28 17:56:38', '2022-01-28 17:56:38'),
(13170, 20067, 20186, NULL, '2022-02-11 00:00:00.000', 'Not Eligible', 'Email received from: dulce.lumbrera@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hi Syed,  Thank you for reaching out. Please see attached for a response to the letter of interest that was presented at the Board of Director meeting. Thank you', NULL, NULL, '2022-02-04 10:51:24', '2022-02-04 10:51:24'),
(13171, 3040, 20187, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:56:42', '2021-03-12 13:56:42'),
(13172, 3040, 20187, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:30', '2021-06-01 14:32:30'),
(13173, 1005, 20187, NULL, '2021-06-09 00:00:00.000', 'Not Eligible', 'The provider Moses Campos is no longer with Valley Med Urgent Care', NULL, NULL, '2021-06-01 14:35:29', '2021-06-01 14:35:29'),
(13174, 3040, 20188, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:56:56', '2021-03-12 13:56:56'),
(13175, 3040, 20188, NULL, '2021-06-08 00:00:00.000', 'On Hold', 'Facility/ Ancillary network interest form submitted. Please see group task.   ', NULL, NULL, '2021-06-01 14:32:34', '2021-06-01 14:32:34'),
(13176, 3040, 20188, NULL, '2021-07-27 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com   Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,   Hope you are doing well. I wanted to know the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thanks ', NULL, NULL, '2021-07-20 14:04:12', '2021-07-20 14:04:12'),
(13177, 3040, 20188, NULL, '2021-08-04 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,  Please advise the enrollment status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below locations.   Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,   Thanks  ', NULL, NULL, '2021-07-28 14:32:44', '2021-07-28 14:32:44'),
(13178, 3040, 20188, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Email sent to: JENNIFER.PEREZ@cigna.com  Subject: Re: [External] Re: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Jennifer,   Hope you are doing well. I sent the emails which are mentioned on the letter of interest form but I couldn\'t get any reply from their side. Can you please check the status and advise?  Practice Details: Practice Name: Valley Med Urgent Care PLLC (All three locations) Practice Tax-ID# 81-5123542 Practice NPI# 1518404631 Primary Address: 2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Address:101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166   Tertiary Address: 800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Please get back to me as soon as you can get a chance. Waiting for your reply,  Thank you  ', NULL, NULL, '2021-08-17 09:37:11', '2021-08-17 09:37:11'),
(13179, 10057, 20188, NULL, '2021-10-21 00:00:00.000', 'In Process', 'Email Sent To : TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope you are doing well. I wanted to know the enrollment updated status for the below mentioned group in Cigna Healthspring for our group Valley Med Urgent Care PLLC under the below mentioned locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166 Tertiary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248  Looking forward to hearing from you.  Thanks & Regards,', NULL, NULL, '2021-10-14 11:11:32', '2021-10-14 11:11:32'),
(13180, 10057, 20188, NULL, '2021-11-22 00:00:00.000', 'In Process', 'Email Sent To : JENNIFER.PEREZ@cigna.com, TXGQProviderRelations@healthspring.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you well. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Hernandez, Juan	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-11-15 17:52:38', '2021-11-15 17:52:38'),
(13181, 10057, 20188, NULL, '2021-12-07 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Can I get the latest update on the below mentioned request.  Please get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-11-30 13:07:43', '2021-11-30 13:07:43'),
(13182, 10057, 20188, NULL, '2021-12-13 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello,  Hope this email finds you in good health. I want to know the enrollment status for the below mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan  Hernandez	1225617558 Jeniece K  Wert	1659919702 Larry  Wright	1033769765 Teresa  Saavedra	1255676151 Eder  Hernandez	1386956852 Homero  Garcia	1730564857 Deborah  Potter	1861914053 Diego  Naranjo	1568929800 Mayra  Lopez	1265945125  Kindly get back to me as soon as possible.  Thanks & Regards,', NULL, NULL, '2021-12-06 17:41:34', '2021-12-06 17:41:34'),
(13183, 10057, 20188, NULL, '2021-12-20 00:00:00.000', 'In Process', 'Email Sent To : TXGQProviderRelations@healthspring.com, TXMAContracting@cigna.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hey,  I\'m writing this email to check the current status on the below mentioned request. This is my second reminder.  Your earliest response will be highly appreciated.  Thanks & Regards,', NULL, NULL, '2021-12-13 12:46:38', '2021-12-13 12:46:38'),
(13184, 10057, 20188, NULL, '2021-12-27 00:00:00.000', 'In Process', 'Email Received From : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Hello Steve,  The last Letter of Interest that was submitted to Valley Organized Physicians/LVPA was in October of 2018. The LVPA Board of Directors determined that there was no network need and appropriate communication was provided via mail. If the group would like to be reconsidered, please fill out the attached LOI and we can make sure to review during our January 2022 Board of Directors meeting. I is going to be important that you list out all locations as well.  Please let me know if you have any other questions.  Thank you, Iliana', NULL, NULL, '2021-12-20 11:48:42', '2021-12-20 11:48:42'),
(13185, 10057, 20188, NULL, '2022-01-03 00:00:00.000', 'In Process', 'Email Sent To : iliana.cortez@careallies.com  Sub : Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring ||  Thank you for reaching out. Please find the attached LOI for groups and providers.  Group Name	Valley Med Urgent Care PLLC (All three locations) Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd Brownsville , TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd Brownsville , TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170 McAllen , TX 78501-1166  Provider Name	NPI Juan Hernandez	1225617558 Wert, Jeniece K	1659919702 Wright, Larry	1033769765 Saavedra, Teresa	1255676151 Hernandez, Eder	1386956852 Garcia, Homero	1730564857 Potter, Deborah	1861914053 Naranjo, Diego	1568929800 Lopez, Mayra	1265945125 Escobar, Angiollet	1962917997 Rodriguez, Cynthia	1124282553  Please revert back to me once you have the update. Have a great day!  Regards,', NULL, NULL, '2021-12-27 11:10:31', '2021-12-27 11:10:31'),
(13186, 20067, 20188, NULL, '2022-01-12 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Subject: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hello Good Morning,  Hope you are doing well. I want to know the enrollment status for the below-mentioned providers under these locations.  Group Name	Valley Med Urgent Care PLLC Tax ID	81-5123542 Group NPI	1518404631 Primary Location	2534 Boca Chica Blvd, Brownsville, TX 78521-3496 Secondary Location	800 E Alton Gloor Blvd, Brownsville, TX 78526-4248 Tertiary Location	101 E. Expressway 83, Suite #170, McAllen, TX 78501-1166 Provider Name	NPI Juan Hernandez	1225617558 Jeniece Wert	1659919702 Cynthia Rodriguez	1124282553 Deborah Potter	1861914053 Larry Wright	1033769765 Teresa Saavedra	1255676151 Diego Naranjo	1568929800 Eder Hernandez	1386956852 Homero Garcia	1730564857 Angiollet Escobar	1962917997 Mayra Lopez	1265945125   Thanks and Regards, Syed Ahad. ', NULL, NULL, '2022-01-05 12:49:36', '2022-01-05 12:49:36'),
(13187, 20067, 20188, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Hello Syed,     I emailed Steve Albert, but the email bounced back.     We will be meeting with our LVPA and HOPE Board of Directors the week of the  24th where we will be discussing your group. Please fill out 1 LOI for the group with all location listed.  Please email me with any questions that you may have.     Thank you.     Iliana', NULL, NULL, '2022-01-11 13:59:12', '2022-01-11 13:59:12'),
(13188, 20067, 20188, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring  Good afternoon,  Hope all is well with you. The LOI form which you sent me doesn\'t have fields for additional locations. Kindly see the attachment below  Eagerly waiting to hear from you   Thanks and Regards, Syed Ahad.', NULL, NULL, '2022-01-11 14:05:04', '2022-01-11 14:05:04'),
(13189, 20067, 20188, NULL, '2022-01-18 00:00:00.000', 'In Process', 'Email Received from: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Thank you for the updated LOI. I added all locations. We meet with our Board of Directors on January 24th. Will be InTouch. ', NULL, NULL, '2022-01-11 17:50:18', '2022-01-11 17:50:18'),
(13190, 20067, 20188, NULL, '2022-01-25 00:00:00.000', 'In Process', 'Will follow-up next week because the meeting of Board of Directors will be on  24th January', NULL, NULL, '2022-01-18 11:02:16', '2022-01-18 11:02:16'),
(13191, 20067, 20188, NULL, '2022-02-04 00:00:00.000', 'In Process', 'Email sent to: iliana.cortez@careallies.com  Sub: Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Good Evening! Hope this email finds you well. Any updates on the request?  Eagerly waiting to hear from you, Thanks and Regards,', NULL, NULL, '2022-01-28 17:56:30', '2022-01-28 17:56:30'),
(13192, 20067, 20188, NULL, '2022-02-11 00:00:00.000', 'Not Eligible', 'Email received from: dulce.lumbrera@careallies.com  Sub:  Group Enrollment || Valley Med Urgent Care PLLC || Group || Cigna Healthspring   Hi Syed,  Thank you for reaching out. Please see attached for a response to the letter of interest that was presented at the Board of Director meeting. Thank you', NULL, NULL, '2022-02-04 10:51:07', '2022-02-04 10:51:07'),
(13193, 3046, 20189, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-12 13:57:03', '2021-03-12 13:57:03'),
(13194, 3040, 20189, NULL, '2021-06-15 00:00:00.000', 'In Process', 'Email sent to: tx_standard_contracting_team@bcbstx.com, Provider_Relations_Houston@bcbstx.com  Subject: Location Addition || George West Medical Clinic || Group || BCBS ||  Greetings,  Hope you are doing well. I wanted to add the below mentioned location in Humana in our group George West Medical Clinic.   Practice Name: George West Medical Clinic Practice NPI# 1427509264 Practice Tax ID# 81-1890349 Practice Address: 504A Houston Street George West , TX 78022-3663  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-06-08 17:14:48', '2021-06-08 17:14:48'),
(13195, 1006, 20189, NULL, '2021-07-05 00:00:00.000', 'In Process', 'We received the following reply from Texas Standand Contracting tx_standard_contracting_team@bcbstx.com:  Sub: Location Addition || George West Medical Clinic || Group || BCBS || : Case Number - 02533924  \"Good morning,  The above group is not in BCBSTX system with tax id or NPI provided.   Thank you, Tx Standard Contracting Team\"  Sent reply: \"Hello,  Please let me know if you can find the following group: Group Name: Coastal Bend Urgent Care, LLC NPI# 1427509264 TIN# 81-1890349  We wish to add the following secondary address under the above-mentioned group:  Secondary Address: 504A Houston Street, George West, TX 78022-3663  Please let me know what is required to get this updated. Thank you.\"', NULL, NULL, '2021-06-28 17:07:37', '2021-06-28 17:07:37'),
(13196, 1006, 20189, NULL, '2021-08-13 00:00:00.000', 'In Process', 'Sent f/u email @ Texas Standand Contracting tx_standard_contracting_team@bcbstx.com:  Sub; Location Addition || George West Medical Clinic || Group || BCBS || : Case Number - 02533924  \"Hello,   I\'m still waiting on an update for this query. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-06 12:25:34', '2021-08-06 12:25:34');
