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
(24086, 11056, 22378, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:35', '2021-10-13 16:49:35'),
(24087, 11056, 22378, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:33:30', '2021-10-20 14:33:30'),
(24088, 11056, 22378, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:56', '2021-11-10 17:38:56'),
(24089, 11056, 22378, NULL, '2021-12-01 00:00:00.000', 'In Process', 'Rep: Lynn M  Status: Have placed a request for the group agreement for us.  Refcode: 11222021 ', NULL, NULL, '2021-11-24 15:45:27', '2021-11-24 15:45:27'),
(24090, 11056, 22378, NULL, '2021-12-17 00:00:00.000', 'In Process', 'Email sent to:  pdsdallas@aetna.com  Sub: Fwd: Additional location status request - RHC - First Health  Good afternoon!   Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415    Kindly do us a favor. Confirm with the Effective Dates soon.    Thank you! Have a wonderful day!', NULL, NULL, '2021-12-10 17:29:11', '2021-12-10 17:29:11'),
(24091, 11056, 22378, NULL, '2021-12-23 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019. Urgent Care Contract.  Please see the attached agreement.  Refcode: 12162021lynnm', NULL, NULL, '2021-12-16 17:04:57', '2021-12-16 17:04:57'),
(24092, 3046, 22379, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:39', '2021-03-16 15:57:39'),
(24093, 1006, 22379, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:03', '2021-03-25 17:34:03'),
(24094, 9057, 22379, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:45:36', '2021-05-25 10:45:36'),
(24095, 9057, 22379, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:05:59', '2021-05-26 13:05:59'),
(24096, 3040, 22379, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:54', '2021-06-15 16:30:54'),
(24097, 11056, 22379, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:53:56', '2021-07-01 14:53:56'),
(24098, 1006, 22379, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:51:50', '2021-07-07 08:51:50'),
(24099, 1006, 22379, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:29:05', '2021-08-17 17:29:05'),
(24100, 11056, 22379, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:26:23', '2021-09-21 16:26:23'),
(24101, 11056, 22379, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:40:18', '2021-10-01 14:40:18'),
(24102, 11056, 22379, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:29', '2021-10-13 16:49:29'),
(24103, 11056, 22379, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:33:25', '2021-10-20 14:33:25'),
(24104, 11056, 22379, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:49', '2021-11-10 17:38:49'),
(24105, 11056, 22379, NULL, '2021-11-29 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019  Refcode: 11222021  Please see the attachment', NULL, NULL, '2021-11-22 17:27:38', '2021-11-22 17:27:38'),
(24106, 3046, 22380, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:42', '2021-03-16 15:57:42'),
(24107, 1006, 22380, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:08', '2021-03-25 17:34:08'),
(24108, 9057, 22380, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:45:44', '2021-05-25 10:45:44'),
(24109, 9057, 22380, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:09', '2021-05-26 13:06:09'),
(24110, 3040, 22380, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:48', '2021-06-15 16:30:48'),
(24111, 11056, 22380, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:54:06', '2021-07-01 14:54:06'),
(24112, 1006, 22380, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:51:54', '2021-07-07 08:51:54'),
(24113, 1006, 22380, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:29:01', '2021-08-17 17:29:01'),
(24114, 11056, 22380, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:26:18', '2021-09-21 16:26:18'),
(24115, 11056, 22380, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:40:10', '2021-10-01 14:40:10'),
(24116, 11056, 22380, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:23', '2021-10-13 16:49:23'),
(24117, 11056, 22380, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:33:18', '2021-10-20 14:33:18'),
(24118, 11056, 22380, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:40', '2021-11-10 17:38:40'),
(24119, 11056, 22380, NULL, '2021-11-29 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019  Refcode: 11222021  Please see the attachment', NULL, NULL, '2021-11-22 17:26:56', '2021-11-22 17:26:56'),
(24120, 3046, 22381, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:44', '2021-03-16 15:57:44'),
(24121, 1006, 22381, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:12', '2021-03-25 17:34:12'),
(24122, 9057, 22381, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:45:50', '2021-05-25 10:45:50'),
(24123, 9057, 22381, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:17', '2021-05-26 13:06:17'),
(24124, 3040, 22381, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:43', '2021-06-15 16:30:43'),
(24125, 11056, 22381, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:54:13', '2021-07-01 14:54:13'),
(24126, 1006, 22381, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:51:57', '2021-07-07 08:51:57'),
(24127, 1006, 22381, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:57', '2021-08-17 17:28:57'),
(24128, 11056, 22381, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:26:13', '2021-09-21 16:26:13'),
(24129, 11056, 22381, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:40:04', '2021-10-01 14:40:04'),
(24130, 11056, 22381, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:13', '2021-10-13 16:49:13'),
(24131, 11056, 22381, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:33:12', '2021-10-20 14:33:12'),
(24132, 11056, 22381, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:33', '2021-11-10 17:38:33'),
(24133, 11056, 22381, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep: Teresita D  Status: Approved Eff date: 6/1/21  Refcode: 111821teresitad', NULL, NULL, '2021-11-18 16:36:08', '2021-11-18 16:36:08'),
(24134, 3046, 22382, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:45', '2021-03-16 15:57:45'),
(24135, 1006, 22382, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:15', '2021-03-25 17:34:15'),
(24136, 9057, 22382, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:45:55', '2021-05-25 10:45:55'),
(24137, 9057, 22382, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:24', '2021-05-26 13:06:24'),
(24138, 3040, 22382, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:38', '2021-06-15 16:30:38'),
(24139, 11056, 22382, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:54:42', '2021-07-01 14:54:42'),
(24140, 1006, 22382, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:01', '2021-07-07 08:52:01'),
(24141, 1006, 22382, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:29:14', '2021-08-17 17:29:14'),
(24142, 11056, 22382, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:26:08', '2021-09-21 16:26:08'),
(24143, 11056, 22382, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:56', '2021-10-01 14:39:56'),
(24144, 11056, 22382, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:08', '2021-10-13 16:49:08'),
(24145, 11056, 22382, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:33:05', '2021-10-20 14:33:05'),
(24146, 11056, 22382, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:26', '2021-11-10 17:38:26'),
(24147, 11056, 22382, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep: Cris S  Status: Approved  Eff date: 6/1/21  Refcode : 11182021', NULL, NULL, '2021-11-18 15:13:42', '2021-11-18 15:13:42'),
(24148, 3046, 22383, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:47', '2021-03-16 15:57:47'),
(24149, 1006, 22383, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:19', '2021-03-25 17:34:19'),
(24150, 9057, 22383, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:02', '2021-05-25 10:46:02');
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
(24151, 9057, 22383, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:31', '2021-05-26 13:06:31'),
(24152, 3040, 22383, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:33', '2021-06-15 16:30:33'),
(24153, 11056, 22383, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:54:55', '2021-07-01 14:54:55'),
(24154, 1006, 22383, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:05', '2021-07-07 08:52:05'),
(24155, 1006, 22383, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:51', '2021-08-17 17:28:51'),
(24156, 11056, 22383, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:26:01', '2021-09-21 16:26:01'),
(24157, 11056, 22383, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:50', '2021-10-01 14:39:50'),
(24158, 11056, 22383, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:49:03', '2021-10-13 16:49:03'),
(24159, 11056, 22383, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:32:58', '2021-10-20 14:32:58'),
(24160, 11056, 22383, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:20', '2021-11-10 17:38:20'),
(24161, 11056, 22383, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:21', '2021-11-10 17:38:21'),
(24162, 11056, 22383, NULL, '2021-11-29 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019  Refcode: 11222021  Please see the attachment', NULL, NULL, '2021-11-22 17:25:55', '2021-11-22 17:25:55'),
(24163, 3046, 22384, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:48', '2021-03-16 15:57:48'),
(24164, 1006, 22384, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:23', '2021-03-25 17:34:23'),
(24165, 9057, 22384, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:10', '2021-05-25 10:46:10'),
(24166, 9057, 22384, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:42', '2021-05-26 13:06:42'),
(24167, 3040, 22384, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:27', '2021-06-15 16:30:27'),
(24168, 11056, 22384, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:55:04', '2021-07-01 14:55:04'),
(24169, 1006, 22384, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:08', '2021-07-07 08:52:08'),
(24170, 1006, 22384, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:48', '2021-08-17 17:28:48'),
(24171, 11056, 22384, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:25:56', '2021-09-21 16:25:56'),
(24172, 11056, 22384, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:42', '2021-10-01 14:39:42'),
(24173, 11056, 22384, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:48:57', '2021-10-13 16:48:57'),
(24174, 11056, 22384, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:32:48', '2021-10-20 14:32:48'),
(24175, 11056, 22384, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:14', '2021-11-10 17:38:14'),
(24176, 11056, 22384, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep: Cris S  Status: Approved Eff date: 11/1/2019  Refcode : 11182021  Please see the attachment.', NULL, NULL, '2021-11-18 14:59:05', '2021-11-18 14:59:05'),
(24177, 3046, 22385, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:50', '2021-03-16 15:57:50'),
(24178, 1006, 22385, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:27', '2021-03-25 17:34:27'),
(24179, 9057, 22385, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:17', '2021-05-25 10:46:17'),
(24180, 9057, 22385, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:06:52', '2021-05-26 13:06:52'),
(24181, 3040, 22385, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:22', '2021-06-15 16:30:22'),
(24182, 11056, 22385, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:55:33', '2021-07-01 14:55:33'),
(24183, 1006, 22385, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:12', '2021-07-07 08:52:12'),
(24184, 1006, 22385, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:44', '2021-08-17 17:28:44'),
(24185, 11056, 22385, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:25:50', '2021-09-21 16:25:50'),
(24186, 11056, 22385, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:34', '2021-10-01 14:39:34'),
(24187, 11056, 22385, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:48:48', '2021-10-13 16:48:48'),
(24188, 11056, 22385, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:32:39', '2021-10-20 14:32:39'),
(24189, 11056, 22385, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:08', '2021-11-10 17:38:08'),
(24190, 11056, 22385, NULL, '2021-11-25 00:00:00.000', 'Approved', 'Rep: Teresita D  Status: Approved Eff date: 11/1/21  Refcode: 111821teresitad', NULL, NULL, '2021-11-18 16:41:42', '2021-11-18 16:41:42'),
(24191, 3046, 22386, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:57:52', '2021-03-16 15:57:52'),
(24192, 1006, 22386, NULL, '2021-04-01 00:00:00.000', 'Initiated', 'Submitted LOI & W9 for addition location to Urgentcare contract. Sent email @ pdsdallas@aetna.com ', NULL, NULL, '2021-03-25 17:34:31', '2021-03-25 17:34:31'),
(24193, 9057, 22386, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pdsdallas@aetna.com  Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TXIN# 46-0575924  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 10:46:23', '2021-05-25 10:46:23'),
(24194, 9057, 22386, NULL, '2021-06-02 00:00:00.000', 'In Process', 'We sent an email to: pdsdallas@aetna.com Sub: Additional location status request - RHC - First Health  Hello, We submitted a request for additional location to our urgent care contract under the following group  and providers.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provide Details Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415     Provider 3: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider 4: Provider Name: Trevino, Rose Provider NPI# 1437174794 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363   Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :5 Provider Name: Ayarzagoitia, Patrick  Provider NPI#   1649568239 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :6 Provider Name: Mason, Traci Provider NPI#   1497127831 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider :7 Provider Name: Svatek, Maegan Provider NPI#   1639670250 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:8 Provider Name: Capupus, Mari Provider NPI#   NPI: 1740517945 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Provider:9 Provider Name: Rogers, Petina Provider NPI#   1801443916 Additional  Location: 3817 South Padre Island Drive Corpus Christi , TX 78415   Kindly provide the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-26 13:07:09', '2021-05-26 13:07:09'),
(24195, 3040, 22386, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Email sent to: pdsdallas@aetna.com  Subject: Additional location status request - RHC - First Health  Hello,   I wanted to get an update on the status of this request, please get back to me as soon as possible.  Thank you! ', NULL, NULL, '2021-06-15 16:30:16', '2021-06-15 16:30:16'),
(24196, 11056, 22386, NULL, '2021-07-09 00:00:00.000', 'In Process', 'Email received from : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Brad,  Please share practice location phone and Fax numbers so that we can proceed further.  Regards, Bharath  Email sent to : BharathB@aetna.com  Sub : Additional location status request - RHC - First Health  Hi Bharath,  Hope you are doing well. Here is the information you asked for about the practice.  Practice Detail: Practice Name : Statcare Minor Emergency Clinic Practice Phone : 361-516-0800 Practice Fax : 361-516-0855   If you need any further information feel free to contact me. Waiting to hear from you soon. Thank you! ', NULL, NULL, '2021-07-01 14:55:48', '2021-07-01 14:55:48'),
(24197, 1006, 22386, NULL, '2021-07-14 00:00:00.000', 'In Process', 'We received the following reply from Bharath, Bollu BharathB@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hi Brad,  Following up on the below email. Please assist  Regards, Bharath\"  Replied:   \"Hello Bollu,   Sure thing, here\'s the information: Address: 500 E CAESAR, KINGSVILLE, TX 78363   Phone# 361-516-0800 Fax# 361-516-0855  Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone#  361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required.  Thank you. \"', NULL, NULL, '2021-07-07 08:52:16', '2021-07-07 08:52:16'),
(24198, 1006, 22386, NULL, '2021-08-24 00:00:00.000', 'In Process', 'Sent f/u email @ \"Bharath, Bollu\" BharathB@aetna.com & pdsdallas@aetna.com:  Sub: Additional location status request - RHC - First Health  \"Hello Bollu,   I appreciate the update, from what I can see from the First Health directory there seems to have been some confusion.   We want all of the following mentioned practice addresses listed under all of the given providers:  Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  Please let me know if you need anything to get these updated.  Thank you.\"', NULL, NULL, '2021-08-17 17:28:40', '2021-08-17 17:28:40'),
(24199, 11056, 22386, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Email sent to : pdsdallas@aetna.com>  Sub : Fwd: Additional location status request - RHC - First Health  Good evening!  Hope all is well with you. I want all of the following mentioned practice addresses listed under all of the given providers. Please update me with the latest credentialing status of these providers too.  Practice Details: Group Name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363 Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410 Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Provider Details: Provider Name: Rose Trevino NPI# 1437174794  Provider Name: Katherine Rabagos NPI# 1134415631  Provider Name: Mary Gonzalez NPI# 1952713083  Provider Name: William Francis NPI# 1457994436  Provider Name: Juan Capupus NPI# 1891168597  Provider Name: Maegan Svatek NPI# 1639670250  Provider Name: Petina Rogers NPI# 1801443916  Provider Name: Traci Mason NPI# 1497127831  Provider Name: Mari Capupus NPI# 1740517945  Provider Name: Patrick Ayarzagoitia NPI# 1649568239  If you have any questions or concerns or require any documents or information, please contact me without any hesitation. Waiting for your response.  Thank you! Have a great day!', NULL, NULL, '2021-09-21 16:25:45', '2021-09-21 16:25:45'),
(24200, 11056, 22386, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Email received from : MadirajuP@aetna.com  Sub : Fwd: Additional location status request - RHC - First Health  Hi,  All the Providers has been added with the given locations.   Thank You,  Phani ', NULL, NULL, '2021-10-01 14:39:27', '2021-10-01 14:39:27'),
(24201, 11056, 22386, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub  : Fwd: Additional location status request - RHC - First Health  Good morning!  Hope you are doing great. Please provide the approval letters and executed contract for the facility & providers as soon as possible. I will be eagerly waiting for it.  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, '2021-10-13 16:48:42', '2021-10-13 16:48:42'),
(24202, 11056, 22386, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : SidleyJ1@firsthealth.com  Sub : Fwd: Additional location status request - RHC - First Health  Hello Ahmed,    I hope that this email finds you well!  Please see attached copy of the contract on file for the practice. The practices group ID when submitting updates to the Data Team is 1067518.   I personally did not send out the welcome letter so I do not have the file to send over. The welcome letters during that time are outdated now so the information would be different than what we currently use. Any of the welcome letters that I have recently sent have the updated information to reference. Please make sure to always list the group ID number so that the Data Team can locate the file easier and your requests process faster.  I hope that this helps!  Take care,  Jeanette Sidley Network Relations Consultant', NULL, NULL, '2021-10-20 14:32:12', '2021-10-20 14:32:12'),
(24203, 11056, 22386, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : SidleyJ1@firsthealth.com  Sub : RE: [SEND SECURE] RE: [EXTERNAL] Re: Additional location status request - RHC - First Health Fwd: Additional location status request - RHC - First Health  Good morning!     Hope you are doing great. We have four locations under the facility tax I.D. Two of them are already listed under the providers and facility but the other highlighted ones were remaining. Miss Phani informed us that the all locations are loaded, therefore, we need the effective dates and some kind of letter for proof for our providers.     Kindly do us a favor. Confirm with the Effective Dates soon.     Thank you!  Have a wonderful day!     Practice Name: Statcare Minor Emergency Clinic  NPI# 1689924904  TIN# 46-0575924     Primary Address: 500 E CAESAR, KINGSVILLE, TX 78363  Secondary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413  Tertiary Address: 4042 River Hill, Corpus Christi, TX 78410  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415', NULL, NULL, '2021-11-10 17:38:02', '2021-11-10 17:38:02'),
(24204, 11056, 22386, NULL, '2021-11-29 00:00:00.000', 'Approved', 'Rep: Lynn M  Status: Approved and effective 11/01/2019  Refcode: 11222021  Please see the attachment', NULL, NULL, '2021-11-22 17:24:25', '2021-11-22 17:24:25'),
(24205, 3046, 22387, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:59:52', '2021-03-16 15:59:52'),
(24206, 3040, 22387, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:23', '2021-03-29 17:13:23'),
(24207, 3040, 22387, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:30:54', '2021-03-30 09:30:54'),
(24208, 3040, 22387, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154', NULL, NULL, '2021-03-30 09:31:47', '2021-03-30 09:31:47'),
(24209, 9057, 22387, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:03', '2021-05-26 16:17:03');
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
(24210, 1006, 22387, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:49', '2021-06-15 16:49:49'),
(24211, 1006, 22387, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:49', '2021-06-18 13:12:49'),
(24212, 3046, 22388, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:59:54', '2021-03-16 15:59:54'),
(24213, 3040, 22388, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:16', '2021-03-29 17:13:16'),
(24214, 3040, 22388, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 09:33:38', '2021-03-30 09:33:38'),
(24215, 3040, 22388, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:34:32', '2021-03-30 09:34:32'),
(24216, 9057, 22388, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:11', '2021-05-26 16:17:11'),
(24217, 1006, 22388, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:46', '2021-06-15 16:49:46'),
(24218, 1006, 22388, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:44', '2021-06-18 13:12:44'),
(24219, 3046, 22389, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:59:55', '2021-03-16 15:59:55'),
(24220, 3040, 22389, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:13', '2021-03-29 17:13:13'),
(24221, 3040, 22389, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:35:11', '2021-03-30 09:35:11'),
(24222, 3040, 22389, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:35:34', '2021-03-30 09:35:34'),
(24223, 9057, 22389, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:19', '2021-05-26 16:17:19'),
(24224, 1006, 22389, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:43', '2021-06-15 16:49:43'),
(24225, 1006, 22389, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:38', '2021-06-18 13:12:38'),
(24226, 3046, 22390, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:59:57', '2021-03-16 15:59:57'),
(24227, 3040, 22390, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:10', '2021-03-29 17:13:10'),
(24228, 3040, 22390, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 09:36:22', '2021-03-30 09:36:22'),
(24229, 3040, 22390, NULL, '2021-04-06 00:00:00.000', 'In Process', ' Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:36:34', '2021-03-30 09:36:34'),
(24230, 9057, 22390, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:28', '2021-05-26 16:17:28'),
(24231, 1006, 22390, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:40', '2021-06-15 16:49:40'),
(24232, 1006, 22390, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:33', '2021-06-18 13:12:33'),
(24233, 3046, 22391, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 15:59:58', '2021-03-16 15:59:58'),
(24234, 3040, 22391, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:01', '2021-03-29 17:13:01'),
(24235, 3040, 22391, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 09:44:34', '2021-03-30 09:44:34'),
(24236, 3040, 22391, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:44:54', '2021-03-30 09:44:54'),
(24237, 9057, 22391, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:34', '2021-05-26 16:17:34'),
(24238, 1006, 22391, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:37', '2021-06-15 16:49:37'),
(24239, 1006, 22391, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:27', '2021-06-18 13:12:27'),
(24240, 3046, 22392, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:00:00', '2021-03-16 16:00:00'),
(24241, 3040, 22392, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:12:34', '2021-03-29 17:12:34'),
(24242, 3040, 22392, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:37:15', '2021-03-30 09:37:15'),
(24243, 3040, 22392, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:37:32', '2021-03-30 09:37:32'),
(24244, 9057, 22392, NULL, '2021-06-03 00:00:00.000', 'In Process', 'Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:17:43', '2021-05-26 16:17:43'),
(24245, 1006, 22392, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:34', '2021-06-15 16:49:34'),
(24246, 1006, 22392, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:23', '2021-06-18 13:12:23'),
(24247, 3046, 22393, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:00:01', '2021-03-16 16:00:01'),
(24248, 3040, 22393, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:13:04', '2021-03-29 17:13:04'),
(24249, 3040, 22393, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:39:51', '2021-03-30 09:39:51'),
(24250, 3040, 22393, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:40:06', '2021-03-30 09:40:06'),
(24251, 9057, 22393, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to Dmarley@ghn-mci.com Sub: Enrollment & Additional Location status request - RHC - Galaxy Health   Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:19:00', '2021-05-26 16:19:00'),
(24252, 1006, 22393, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:31', '2021-06-15 16:49:31'),
(24253, 1006, 22393, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:17', '2021-06-18 13:12:17'),
(24254, 3046, 22394, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:00:03', '2021-03-16 16:00:03'),
(24255, 3040, 22394, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:12:22', '2021-03-29 17:12:22'),
(24256, 3040, 22394, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:40:44', '2021-03-30 09:40:44'),
(24257, 3040, 22394, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:40:59', '2021-03-30 09:40:59'),
(24258, 9057, 22394, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to Dmarley@ghn-mci.com Sub: Enrollment & Additional Location status request - RHC - Galaxy Health   Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:19:11', '2021-05-26 16:19:11'),
(24259, 1006, 22394, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:28', '2021-06-15 16:49:28'),
(24260, 1006, 22394, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:12:08', '2021-06-18 13:12:08'),
(24261, 3046, 22395, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:00:04', '2021-03-16 16:00:04'),
(24262, 3040, 22395, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:12:14', '2021-03-29 17:12:14');
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
(24263, 3040, 22395, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-30 09:41:35', '2021-03-30 09:41:35'),
(24264, 3040, 22395, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:41:47', '2021-03-30 09:41:47'),
(24265, 9057, 22395, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to Dmarley@ghn-mci.com Sub: Enrollment & Additional Location status request - RHC - Galaxy Health   Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:19:19', '2021-05-26 16:19:19'),
(24266, 1006, 22395, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:25', '2021-06-15 16:49:25'),
(24267, 1006, 22395, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:11:53', '2021-06-18 13:11:53'),
(24268, 3046, 22396, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:00:06', '2021-03-16 16:00:06'),
(24269, 3040, 22396, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: Dmarley@ghn-mci.com  Subject: Location Addition || Statcare Minor Emergency Clinic || Group & Providers || Galaxy Health ||  Greetings,   Hope you are doing well. I wanted to add the providers in the Galaxy Health for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415    If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you   ', NULL, NULL, '2021-03-29 17:12:07', '2021-03-29 17:12:07'),
(24270, 3040, 22396, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email sent to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Good Morning Daniel,   I really appreciate your prompt response. As per your above email I sent the addendum for the addition of the facility through fax.   If you need any additional information please let me know. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-30 09:42:18', '2021-03-30 09:42:18'),
(24271, 3040, 22396, NULL, '2021-04-06 00:00:00.000', 'In Process', 'Email rcvd to: dmarley@ghn-mci.com  Subject: StatCare Minor Emergency Clinic  Hi Adil,  I am writing you in response to an e-mail that you sent requesting to add locations to an agreement for StatCare Minor Emergency Clinic. Attached please find an addendum for the addition of facilities for the facilities to review. If it meets with their approval, please have it filled out and return a partially executed copy signed by an Authorized signatory of the facilities via fax to 1-800-645-0154 for processing.  Thanks, in advance, and please do not hesitate to contact me directly, if I can be of any further assistance, I am happy to help.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154 ', NULL, NULL, '2021-03-30 09:42:34', '2021-03-30 09:42:34'),
(24272, 9057, 22396, NULL, '2021-06-03 00:00:00.000', 'In Process', 'We sent an email to Dmarley@ghn-mci.com Sub: Enrollment & Additional Location status request - RHC - Galaxy Health   Hello, We submitted a request for the enrollment & Location addition of providers under the following group  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239    Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597    Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945    Provider 4: Provider Name: Mason, Traci Smith Provider NPI# 1497127831    Provider 5: Provider Name: Rabagos, Katherine Provider NPI# 134415631    Provider 6: Provider Name: Rogers, Petina L. Provider NPI# 1801443916    Provider 7: Provider Name: Svatek, Maegan Provider NPI# 1639670250    Provider 8: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794    Provider 9: Provider Name: Francis, William Robert Provider NPI# 1457994436    Provider 10: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083    Kindly update me the current status of the above mentioned request as soon as possible.  Thank you ', NULL, NULL, '2021-05-26 16:19:28', '2021-05-26 16:19:28'),
(24273, 1006, 22396, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Daniel Marley Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Hello Daniel,   I hope you\'re doing well, I wanted to check in again on the location update for the following group and providers.   Please get back to me as soon as possible. Thank you!\"', NULL, NULL, '2021-06-15 16:49:21', '2021-06-15 16:49:21'),
(24274, 1006, 22396, NULL, '2021-06-25 00:00:00.000', 'Approved', 'We received the following location confirmation from Dmarley@ghn-mci.com:  Sub: Enrollment & Additional Location status request - RHC - Galaxy Health  \"Sir,  The new facility location at 3817 South Padre Island Dr shows effective 3-30-2021. This is a facility contract not a physician agreement. If the physicians bill under the facility’s Tax Id they would not need to be added.  Thanks,  Daniel M. Contract Specialist Galaxy Health Network (P) 800-975-3322 X 1124 (F) 1-800-645-0154\"  Approval Confirmation is attached for reference. ', NULL, NULL, '2021-06-18 13:11:48', '2021-06-18 13:11:48'),
(24275, 3046, 22397, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:09', '2021-03-16 16:02:09'),
(24276, 3040, 22397, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:35:01', '2021-03-29 15:35:01'),
(24277, 9057, 22397, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:01:23', '2021-05-25 11:01:23'),
(24278, 9057, 22397, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:38:32', '2021-05-28 10:38:32'),
(24279, 1006, 22397, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:54', '2021-06-15 16:44:54'),
(24280, 1006, 22397, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 11/01/2019', NULL, NULL, '2021-06-17 14:14:18', '2021-06-17 14:14:18'),
(24281, 3046, 22398, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:10', '2021-03-16 16:02:10'),
(24282, 3040, 22398, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:55', '2021-03-29 15:34:55'),
(24283, 9057, 22398, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:01:53', '2021-05-25 11:01:53'),
(24284, 9057, 22398, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:38:51', '2021-05-28 10:38:51'),
(24285, 1006, 22398, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:50', '2021-06-15 16:44:50'),
(24286, 1006, 22398, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 03/01/2019', NULL, NULL, '2021-06-17 14:13:50', '2021-06-17 14:13:50'),
(24287, 3046, 22399, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:12', '2021-03-16 16:02:12'),
(24288, 3040, 22399, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:45', '2021-03-29 15:34:45'),
(24289, 9057, 22399, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:02:08', '2021-05-25 11:02:08'),
(24290, 9057, 22399, NULL, '2021-06-04 00:00:00.000', 'New/Not Initiated', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:39:07', '2021-05-28 10:39:07'),
(24291, 9057, 22399, NULL, '2021-06-04 00:00:00.000', 'In Process', '', NULL, NULL, '2021-05-28 10:41:51', '2021-05-28 10:41:51'),
(24292, 1006, 22399, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:47', '2021-06-15 16:44:47'),
(24293, 1006, 22399, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 03/01/2019', NULL, NULL, '2021-06-17 14:12:25', '2021-06-17 14:12:25'),
(24294, 3046, 22400, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:13', '2021-03-16 16:02:13'),
(24295, 3040, 22400, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Health smart for our group Statcare Minor Emergency Clinic under the below mentioned locations.   Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:48:32', '2021-03-29 15:48:32'),
(24296, 3040, 22400, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,   Please find the attached CAQH access form for the providers that were requested in your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-04-16 07:31:53', '2021-04-16 07:31:53'),
(24297, 9057, 22400, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We Received an email from mdiprsupport@healthsmart.com  They asked for the submission of form for this provider, now we have submitted it. Attached is reference', NULL, NULL, '2021-05-28 09:48:42', '2021-05-28 09:48:42'),
(24298, 9057, 22400, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:39:20', '2021-05-28 10:39:20'),
(24299, 1006, 22400, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:44', '2021-06-15 16:44:44'),
(24300, 1006, 22400, NULL, '2021-06-24 00:00:00.000', 'Approved', 'William Francis - Eff: 01/01/2021 Ref# 2046862  Location addition has been completed, it has been attached for reference. ', NULL, NULL, '2021-06-17 13:56:40', '2021-06-17 13:56:40'),
(24301, 3046, 22401, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:14', '2021-03-16 16:02:14'),
(24302, 3040, 22401, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Health smart for our group Statcare Minor Emergency Clinic under the below mentioned locations.   Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:48:58', '2021-03-29 15:48:58'),
(24303, 3040, 22401, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,   Please find the attached CAQH access form for the providers that were requested in your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-04-16 07:35:09', '2021-04-16 07:35:09'),
(24304, 1006, 22401, NULL, '2021-05-05 00:00:00.000', 'In Process', 'We received the following email from Leslie.Perez@healthsmart.com:  Sub: Fwd: Mary Gonzalez NPI 1952713083  \"Hello,  I need the following information on Mary Gonzalez NPI 1952713083.  Once, I\'ve obtained this information I will continue to credential this provider.    Copy of current board of specialty --   American Academy of Nurse Practitioners   Thank you,  Leslie Perez Credentialing Specialist 222 W. Las Colinas Blvd., Suite 500N Irving, TX 75039 PH:  214-574-1152   FAX 214-574-2368 Leslie.Perez@HealthSmart.com www.HealthSmart.com\"  We submitted the reply and attached the provider\'s AANP.', NULL, NULL, '2021-04-28 07:31:49', '2021-04-28 07:31:49'),
(24305, 9057, 22401, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:39:35', '2021-05-28 10:39:35'),
(24306, 1006, 22401, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:42', '2021-06-15 16:44:42'),
(24307, 1006, 22401, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Submitted demographic update request @ Provider Relations - South pr.south@healthsmart.com:  Sub: Demographic Update - RHC - HealthSmart  \"Hello,   Please find the attached demographic update request form for our providers, please let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-06-17 17:15:52', '2021-06-17 17:15:52'),
(24308, 1006, 22401, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from MDI PR Support mdiprsupport@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"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 : 77954)  Thanks Healthsmart Provider Relations.\"  Sent f/u email:  \"Hello,   When will these be updated on the provider directory?  Thank you!\" ', NULL, NULL, '2021-06-21 09:05:10', '2021-06-21 09:05:10'),
(24309, 1006, 22401, NULL, '2021-07-12 00:00:00.000', 'Approved', 'The location has been added, location confirmation is attached for reference.   Eff: 06/01/2021', NULL, NULL, '2021-07-05 16:11:09', '2021-07-05 16:11:09'),
(24310, 3046, 22402, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:16', '2021-03-16 16:02:16'),
(24311, 3040, 22402, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:40', '2021-03-29 15:34:40'),
(24312, 9057, 22402, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:02:41', '2021-05-25 11:02:41'),
(24313, 9057, 22402, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:39:47', '2021-05-28 10:39:47'),
(24314, 1006, 22402, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:39', '2021-06-15 16:44:39'),
(24315, 1006, 22402, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 05/02/2019', NULL, NULL, '2021-06-17 14:12:03', '2021-06-17 14:12:03'),
(24316, 3046, 22403, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:18', '2021-03-16 16:02:18'),
(24317, 3040, 22403, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:30', '2021-03-29 15:34:30'),
(24318, 9057, 22403, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:04:28', '2021-05-25 11:04:28'),
(24319, 9057, 22403, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:33:38', '2021-05-28 10:33:38'),
(24320, 1006, 22403, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:36', '2021-06-15 16:44:36'),
(24321, 1006, 22403, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 06/01/2019', NULL, NULL, '2021-06-17 14:11:44', '2021-06-17 14:11:44'),
(24322, 3046, 22404, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:20', '2021-03-16 16:02:20'),
(24323, 3040, 22404, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:24', '2021-03-29 15:34:24');
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
(24324, 9057, 22404, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:04:38', '2021-05-25 11:04:38'),
(24325, 9057, 22404, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:40:04', '2021-05-28 10:40:04'),
(24326, 1006, 22404, NULL, '2021-06-16 00:00:00.000', 'In Process', 'Sent another f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment Status - RHC - Health Smart  \"Hello,   Thank you for the information regarding the effective date, could you please verify if the locations listed are added under the given provider?  Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415  Thank you. \"', NULL, NULL, '2021-06-09 08:26:46', '2021-06-09 08:26:46'),
(24327, 1006, 22404, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:33', '2021-06-15 16:44:33'),
(24328, 1006, 22404, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The location has been added for the provider. Location confirmation is attached for reference.   Eff: 01/01/2020 ', NULL, NULL, '2021-06-17 13:21:33', '2021-06-17 13:21:33'),
(24329, 3046, 22405, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:21', '2021-03-16 16:02:21'),
(24330, 3040, 22405, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Add Location || Statcare Minor Emergency Clinic || Providers || Health Smart ||  Greetings,   Hope you are doing well. I wanted to add the providers in the BCBS for our group Statcare Minor Emergency Clinic under the below locations.  Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 2: Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive  Corpus Christi , TX 78415  Provider 3: Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 4: Provider Name: Francis, William Robert Provider NPI# 1457994436 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 5: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Additional Location: 500 E CAESAR  KINGSVILLE , TX 78363 (Not Showing on directory)  Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 6: Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 7: Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 8: Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Additional Location: 4042 River Hill  Corpus Christi , TX 78410 Additional Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 9: Provider Name: Svatek, Maegan Provider NPI# 1639670250 Additional Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:34:36', '2021-03-29 15:34:36'),
(24331, 9057, 22405, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:04:47', '2021-05-25 11:04:47'),
(24332, 9057, 22405, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:40:15', '2021-05-28 10:40:15'),
(24333, 1006, 22405, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:28', '2021-06-15 16:44:28'),
(24334, 1006, 22405, NULL, '2021-06-24 00:00:00.000', 'Approved', 'The provider location has been updated and the confirmation is attached for reference. Eff: 03/01/2019', NULL, NULL, '2021-06-17 14:11:24', '2021-06-17 14:11:24'),
(24335, 3046, 22406, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:23', '2021-03-16 16:02:23'),
(24336, 3040, 22406, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Health smart for our group Statcare Minor Emergency Clinic under the below mentioned locations.   Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-03-29 15:49:21', '2021-03-29 15:49:21'),
(24337, 3040, 22406, NULL, '2021-04-23 00:00:00.000', 'In Process', 'Email sent to: mdiprsupport@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,   Please find the attached CAQH access form for the providers that were requested in your previous email.   If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you ', NULL, NULL, '2021-04-16 07:37:10', '2021-04-16 07:37:10'),
(24338, 9057, 22406, NULL, '2021-06-04 00:00:00.000', 'New/Not Initiated', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:40:25', '2021-05-28 10:40:25'),
(24339, 9057, 22406, NULL, '2021-06-04 00:00:00.000', 'In Process', NULL, NULL, NULL, '2021-05-28 10:40:35', '2021-05-28 10:40:35'),
(24340, 9057, 22406, NULL, '2021-06-04 00:00:00.000', 'In Process', NULL, NULL, NULL, '2021-05-28 10:40:54', '2021-05-28 10:40:54'),
(24341, 1006, 22406, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:25', '2021-06-15 16:44:25'),
(24342, 1006, 22406, NULL, '2021-06-24 00:00:00.000', 'In Process', 'Submitted demographic update request @ Provider Relations - South pr.south@healthsmart.com:  Sub: Demographic Update - RHC - HealthSmart  \"Hello,   Please find the attached demographic update request form for our providers, please let me know if anything else is required.  Thank you!\"', NULL, NULL, '2021-06-17 17:15:47', '2021-06-17 17:15:47'),
(24343, 1006, 22406, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from MDI PR Support mdiprsupport@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"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 : 77954)  Thanks Healthsmart Provider Relations.\"  Sent f/u email:  \"Hello,   When will these be updated on the provider directory?  Thank you!\" ', NULL, NULL, '2021-06-21 09:05:07', '2021-06-21 09:05:07'),
(24344, 1006, 22406, NULL, '2021-07-12 00:00:00.000', 'Approved', 'The location has been added, location confirmation is attached for reference.   Eff: 06/01/2021', NULL, NULL, '2021-07-05 16:06:49', '2021-07-05 16:06:49'),
(24345, 3046, 22407, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:02:25', '2021-03-16 16:02:25'),
(24346, 1006, 22407, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Email sent to: pr.south@healthsmart.com  Subject: Enroll Providers || Statcare Minor Emergency Clinic || Francis, William Robert, Gonzalez, Mary C & Trevino, Rose Puentes || Health Smart ||  Greetings,  Hope you are doing well. I wanted to enroll the below mentioned providers in Health smart for our group Statcare Minor Emergency Clinic under the below mentioned locations.   Practice Detail: Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider 1: Provider Name: Francis, William Robert Provider NPI# 1457994436  Provider 2: Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider 3: Provider Name: Trevino, Rose Puentes Provider NPI# 1437174794  If you need any additional information please feel free to call or email me. Waiting to hear from you soon.   Thank you  ', NULL, NULL, '2021-03-29 17:07:48', '2021-03-29 17:07:48'),
(24347, 9057, 22407, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to pr.south@healthsmart.com  Sub: Additional location status request - RHC - Health Smart  Hello, We submitted a request for the addition of a location for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 11:05:02', '2021-05-25 11:05:02'),
(24348, 9057, 22407, NULL, '2021-06-04 00:00:00.000', 'In Process', 'We received an email from: mdiprsupport@healthsmart.com They asked to send all the Providers name and  their NPI\'s for the addition of location and we submitted it. ', NULL, NULL, '2021-05-28 10:33:10', '2021-05-28 10:33:10'),
(24349, 1006, 22407, NULL, '2021-06-22 00:00:00.000', 'In Process', 'Sent f/u email @ Provider Relations - South pr.south@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"Hello,  I hope you\'re doing well, I needed to get an update regarding the enrollment and location update status for the following providers under our group, their info is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE, TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi, TX 78413 Tertiary Location: 4042 River Hill Corpus Christi, TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi, TX 78415 Provider Name: Ayarzagoitia, Patrick A. Provider NPI# 1649568239 Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945 Provider Name: Mason, Traci Smith Provider NPI# 1497127831 Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794 Provider Name: Svatek, Maegan Provider NPI# 1639670250 Provider Name: Rogers, Petina L. Provider NPI# 1801443916 Provider Name: Rabagos, Katherine Provider NPI# 1134415631 Provider Name: Francis, William Robert Provider NPI# 1457994436 Provider Name: Capupus, Juan Miguel Provider NPI# 1891168597 Provider Name: Gonzalez, Mary C Provider NPI# 1952713083 Please get back to me as soon as possible.   Thank you!\"', NULL, NULL, '2021-06-15 16:44:22', '2021-06-15 16:44:22'),
(24350, 1006, 22407, NULL, '2021-06-28 00:00:00.000', 'In Process', 'We received the following reply from MDI PR Support mdiprsupport@healthsmart.com:  Sub: Enrollment & Location Status - RHC - HealthSmart  \"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 : 77954)  Thanks Healthsmart Provider Relations.\"  Sent f/u email:  \"Hello,   When will these be updated on the provider directory?  Thank you!\" ', NULL, NULL, '2021-06-21 09:04:58', '2021-06-21 09:04:58'),
(24351, 1006, 22407, NULL, '2021-07-12 00:00:00.000', 'Approved', 'The location has been added for all providers, location confirmation is attached for reference in provider tasks.   Eff: 06/01/2021', NULL, NULL, '2021-07-05 16:11:30', '2021-07-05 16:11:30'),
(24352, 3046, 22408, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:05:48', '2021-03-16 16:05:48'),
(24353, 1006, 22408, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:03:02', '2021-03-29 17:03:02'),
(24354, 1006, 22408, NULL, '2021-05-20 00:00:00.000', 'In Process', 'Received the following email from S TX Network Mgmt stxnm@humana.com:  Sub: RE: Demographic Change  \"In order to add the new Urgent Care locations we will need a facility credentialing application for each location.   Thank you   Becky Solis Network Operations Coordinator – Provider Contracting  South Texas Network Management Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\" Credentialing application filled out and sent back. ', NULL, NULL, '2021-05-10 08:38:54', '2021-05-10 08:38:54'),
(24355, 3040, 22408, NULL, '2021-06-17 00:00:00.000', 'In Process', 'Email rcvd from:  stxnm@humana.com  Subject: Demographic Change  Thank you for your e-mail.  We have successfully received your message and will respond as soon as possible.       DEMOGRAPHIC REQUESTS  Please allow 45-60 days for completion of demographic requests.  You will receive an email notification once your request has been completed.   You may check your demographic information at any time through Humana’s online directory:  https://www.humana.com/finder/medical?pageId=e59a074a04e741fbb164fc08ce8222fe.     OTHER KEY RESOURCES  For all other requests including claims inquiries, contract copies, fee schedules, etc., please contact Humana Provider Relations at 1-800-626-2741. Additional information may be accessed on our website at  https://www.humana.com/provider/medical-resources        Thank you Network Operations Coordinator /Provider Contracting', NULL, NULL, '2021-06-10 12:41:28', '2021-06-10 12:41:28'),
(24356, 1006, 22408, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:48:05', '2021-06-11 14:48:05'),
(24357, 3040, 22408, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:17', '2021-06-30 16:50:17'),
(24358, 1006, 22408, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:43', '2021-07-12 15:55:43'),
(24359, 1006, 22408, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:07:03', '2021-07-29 17:07:03'),
(24360, 1006, 22408, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:48:03', '2021-08-02 09:48:03'),
(24361, 1006, 22408, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:06:06', '2021-08-13 17:06:06'),
(24362, 1006, 22408, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:11:28', '2021-08-23 17:11:28'),
(24363, 11056, 22408, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:39', '2021-09-21 13:05:39'),
(24364, 11056, 22408, NULL, '2021-09-28 00:00:00.000', 'In Process', 'jmarfa@humana.com ', NULL, NULL, '2021-09-21 13:06:22', '2021-09-21 13:06:22'),
(24365, 11056, 22408, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:51:05', '2021-10-01 15:51:05'),
(24366, 11056, 22408, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:39', '2021-10-13 17:01:39'),
(24367, 11056, 22408, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:58:05', '2021-10-20 16:58:05'),
(24368, 11056, 22408, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:57:13', '2021-11-10 17:57:13'),
(24369, 11056, 22408, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:44:28', '2021-11-19 17:44:28'),
(24370, 11056, 22408, NULL, '2021-12-08 00:00:00.000', 'In Process', 'Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:07:31', '2021-12-01 13:07:31'),
(24371, 11056, 22408, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:35', '2021-12-16 13:45:35'),
(24372, 11056, 22408, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:19:53', '2021-12-23 15:19:53'),
(24373, 19067, 22408, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:40', '2022-01-12 16:24:40'),
(24374, 19067, 22408, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:32:01', '2022-01-26 16:32:01'),
(24375, 19067, 22408, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:31:16', '2022-02-11 14:31:16'),
(24376, 19067, 22408, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:44', '2022-02-21 17:24:44'),
(24377, 19067, 22408, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:09', '2022-03-15 16:03:09'),
(24378, 3046, 22409, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:22', '2021-03-16 16:07:22'),
(24379, 1006, 22409, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:01:46', '2021-03-29 17:01:46'),
(24380, 9057, 22409, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to humanahoustonpd@humana.com  Sub: Additional location status request - RHC - Humana  Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you', NULL, NULL, '2021-05-25 12:28:11', '2021-05-25 12:28:11'),
(24381, 1006, 22409, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:48:02', '2021-06-11 14:48:02'),
(24382, 3040, 22409, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:14', '2021-06-30 16:50:14'),
(24383, 1006, 22409, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:40', '2021-07-12 15:55:40'),
(24384, 1006, 22409, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:59', '2021-07-29 17:06:59'),
(24385, 1006, 22409, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:22', '2021-08-02 09:47:22'),
(24386, 1006, 22409, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:06:01', '2021-08-13 17:06:01'),
(24387, 1006, 22409, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:11:20', '2021-08-23 17:11:20'),
(24388, 11056, 22409, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:33', '2021-09-21 13:05:33'),
(24389, 11056, 22409, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:59', '2021-10-01 15:50:59'),
(24390, 11056, 22409, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:32', '2021-10-13 17:01:32'),
(24391, 11056, 22409, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:58', '2021-10-20 16:57:58'),
(24392, 11056, 22409, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:57:07', '2021-11-10 17:57:07'),
(24393, 11056, 22409, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:44:50', '2021-11-19 17:44:50'),
(24394, 11056, 22409, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:07:52', '2021-12-01 13:07:52'),
(24395, 11056, 22409, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:28', '2021-12-16 13:45:28'),
(24396, 11056, 22409, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:11', '2021-12-23 15:20:11'),
(24397, 19067, 22409, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:27', '2022-01-12 16:24:27'),
(24398, 19067, 22409, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:54', '2022-01-26 16:31:54'),
(24399, 19067, 22409, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:31:06', '2022-02-11 14:31:06'),
(24400, 19067, 22409, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:38', '2022-02-21 17:24:38'),
(24401, 19067, 22409, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:14', '2022-03-15 16:03:14'),
(24402, 3046, 22410, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:24', '2021-03-16 16:07:24'),
(24403, 1006, 22410, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:02:15', '2021-03-29 17:02:15'),
(24404, 9057, 22410, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:28:21', '2021-05-25 12:28:21');
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
(24405, 1006, 22410, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:58', '2021-06-11 14:47:58'),
(24406, 3040, 22410, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:12', '2021-06-30 16:50:12'),
(24407, 1006, 22410, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:35', '2021-07-12 15:55:35'),
(24408, 1006, 22410, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:56', '2021-07-29 17:06:56'),
(24409, 1006, 22410, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:30', '2021-08-02 09:47:30'),
(24410, 1006, 22410, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:57', '2021-08-13 17:05:57'),
(24411, 1006, 22410, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:11:14', '2021-08-23 17:11:14'),
(24412, 11056, 22410, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:27', '2021-09-21 13:05:27'),
(24413, 11056, 22410, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:53', '2021-10-01 15:50:53'),
(24414, 11056, 22410, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:22', '2021-10-13 17:01:22'),
(24415, 11056, 22410, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:49', '2021-10-20 16:57:49'),
(24416, 11056, 22410, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:57:03', '2021-11-10 17:57:03'),
(24417, 11056, 22410, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:44:56', '2021-11-19 17:44:56'),
(24418, 11056, 22410, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:07:59', '2021-12-01 13:07:59'),
(24419, 11056, 22410, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:21', '2021-12-16 13:45:21'),
(24420, 11056, 22410, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:15', '2021-12-23 15:20:15'),
(24421, 19067, 22410, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:19', '2022-01-12 16:24:19'),
(24422, 19067, 22410, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:46', '2022-01-26 16:31:46'),
(24423, 19067, 22410, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:59', '2022-02-11 14:30:59'),
(24424, 19067, 22410, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:31', '2022-02-21 17:24:31'),
(24425, 19067, 22410, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:19', '2022-03-15 16:03:19'),
(24426, 3046, 22411, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:26', '2021-03-16 16:07:26'),
(24427, 1006, 22411, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:02:24', '2021-03-29 17:02:24'),
(24428, 9057, 22411, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:28:30', '2021-05-25 12:28:30'),
(24429, 1006, 22411, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:54', '2021-06-11 14:47:54'),
(24430, 3040, 22411, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:10', '2021-06-30 16:50:10'),
(24431, 1006, 22411, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:31', '2021-07-12 15:55:31'),
(24432, 1006, 22411, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:53', '2021-07-29 17:06:53'),
(24433, 1006, 22411, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:36', '2021-08-02 09:47:36'),
(24434, 1006, 22411, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:51', '2021-08-13 17:05:51'),
(24435, 1006, 22411, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:10:36', '2021-08-23 17:10:36'),
(24436, 11056, 22411, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:21', '2021-09-21 13:05:21'),
(24437, 11056, 22411, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:46', '2021-10-01 15:50:46'),
(24438, 11056, 22411, NULL, '2021-10-25 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-18 15:57:31', '2021-10-18 15:57:31'),
(24439, 11056, 22411, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:42', '2021-10-20 16:57:42'),
(24440, 11056, 22411, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:57', '2021-11-10 17:56:57'),
(24441, 11056, 22411, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:01', '2021-11-19 17:45:01'),
(24442, 11056, 22411, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:06', '2021-12-01 13:08:06'),
(24443, 11056, 22411, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:15', '2021-12-16 13:45:15'),
(24444, 11056, 22411, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:20', '2021-12-23 15:20:20'),
(24445, 19067, 22411, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:11', '2022-01-12 16:24:11'),
(24446, 19067, 22411, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:39', '2022-01-26 16:31:39'),
(24447, 19067, 22411, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:54', '2022-02-11 14:30:54'),
(24448, 19067, 22411, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:24', '2022-02-21 17:24:24'),
(24449, 19067, 22411, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:23', '2022-03-15 16:03:23'),
(24450, 3046, 22412, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:28', '2021-03-16 16:07:28'),
(24451, 1006, 22412, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:02:37', '2021-03-29 17:02:37'),
(24452, 9057, 22412, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:28:39', '2021-05-25 12:28:39'),
(24453, 1006, 22412, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:51', '2021-06-11 14:47:51'),
(24454, 3040, 22412, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:08', '2021-06-30 16:50:08'),
(24455, 1006, 22412, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:24', '2021-07-12 15:55:24'),
(24456, 1006, 22412, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:49', '2021-07-29 17:06:49'),
(24457, 1006, 22412, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:39', '2021-08-02 09:47:39'),
(24458, 1006, 22412, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:47', '2021-08-13 17:05:47'),
(24459, 1006, 22412, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:10:25', '2021-08-23 17:10:25'),
(24460, 11056, 22412, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:17', '2021-09-21 13:05:17'),
(24461, 11056, 22412, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:34', '2021-10-01 15:50:34'),
(24462, 11056, 22412, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:13', '2021-10-13 17:01:13'),
(24463, 11056, 22412, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:33', '2021-10-20 16:57:33'),
(24464, 11056, 22412, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:51', '2021-11-10 17:56:51'),
(24465, 11056, 22412, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:07', '2021-11-19 17:45:07'),
(24466, 11056, 22412, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:14', '2021-12-01 13:08:14'),
(24467, 11056, 22412, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:00', '2021-12-16 13:45:00'),
(24468, 11056, 22412, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:25', '2021-12-23 15:20:25'),
(24469, 11056, 22412, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:29', '2021-12-23 15:20:29'),
(24470, 19067, 22412, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:06', '2022-01-12 16:24:06'),
(24471, 19067, 22412, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:33', '2022-01-26 16:31:33'),
(24472, 19067, 22412, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:48', '2022-02-11 14:30:48'),
(24473, 19067, 22412, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:17', '2022-02-21 17:24:17'),
(24474, 19067, 22412, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:28', '2022-03-15 16:03:28'),
(24475, 3046, 22413, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:29', '2021-03-16 16:07:29'),
(24476, 1006, 22413, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:02:51', '2021-03-29 17:02:51'),
(24477, 9057, 22413, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:28:57', '2021-05-25 12:28:57'),
(24478, 1006, 22413, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:47', '2021-06-11 14:47:47'),
(24479, 3040, 22413, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:06', '2021-06-30 16:50:06'),
(24480, 1006, 22413, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:18', '2021-07-12 15:55:18'),
(24481, 1006, 22413, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:46', '2021-07-29 17:06:46'),
(24482, 1006, 22413, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:43', '2021-08-02 09:47:43'),
(24483, 1006, 22413, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:42', '2021-08-13 17:05:42'),
(24484, 1006, 22413, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:10:20', '2021-08-23 17:10:20'),
(24485, 11056, 22413, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:10', '2021-09-21 13:05:10');
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
(24486, 11056, 22413, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:29', '2021-10-01 15:50:29'),
(24487, 11056, 22413, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:07', '2021-10-13 17:01:07'),
(24488, 11056, 22413, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:26', '2021-10-20 16:57:26'),
(24489, 11056, 22413, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:29', '2021-11-10 17:56:29'),
(24490, 11056, 22413, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:13', '2021-11-19 17:45:13'),
(24491, 11056, 22413, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:20', '2021-12-01 13:08:20'),
(24492, 11056, 22413, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:46:17', '2021-12-16 13:46:17'),
(24493, 11056, 22413, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:35', '2021-12-23 15:20:35'),
(24494, 19067, 22413, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:24:00', '2022-01-12 16:24:00'),
(24495, 19067, 22413, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:24', '2022-01-26 16:31:24'),
(24496, 19067, 22413, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:37', '2022-02-11 14:30:37'),
(24497, 19067, 22413, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:11', '2022-02-21 17:24:11'),
(24498, 19067, 22413, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:37', '2022-03-15 16:03:37'),
(24499, 3046, 22414, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:31', '2021-03-16 16:07:31'),
(24500, 1006, 22414, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:03:14', '2021-03-29 17:03:14'),
(24501, 9057, 22414, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:29:06', '2021-05-25 12:29:06'),
(24502, 1006, 22414, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:43', '2021-06-11 14:47:43'),
(24503, 3040, 22414, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:03', '2021-06-30 16:50:03'),
(24504, 1006, 22414, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:15', '2021-07-12 15:55:15'),
(24505, 1006, 22414, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:43', '2021-07-29 17:06:43'),
(24506, 1006, 22414, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:46', '2021-08-02 09:47:46'),
(24507, 1006, 22414, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:38', '2021-08-13 17:05:38'),
(24508, 1006, 22414, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \" ', NULL, NULL, '2021-08-23 17:09:31', '2021-08-23 17:09:31'),
(24509, 11056, 22414, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:05', '2021-09-21 13:05:05'),
(24510, 11056, 22414, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:24', '2021-10-01 15:50:24'),
(24511, 11056, 22414, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:01:01', '2021-10-13 17:01:01'),
(24512, 11056, 22414, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:20', '2021-10-20 16:57:20'),
(24513, 11056, 22414, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:23', '2021-11-10 17:56:23'),
(24514, 11056, 22414, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:17', '2021-11-19 17:45:17'),
(24515, 11056, 22414, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:27', '2021-12-01 13:08:27'),
(24516, 11056, 22414, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:46:06', '2021-12-16 13:46:06'),
(24517, 11056, 22414, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:41', '2021-12-23 15:20:41'),
(24518, 19067, 22414, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:23:54', '2022-01-12 16:23:54'),
(24519, 19067, 22414, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:15', '2022-01-26 16:31:15'),
(24520, 19067, 22414, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:31', '2022-02-11 14:30:31'),
(24521, 19067, 22414, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:24:02', '2022-02-21 17:24:02'),
(24522, 19067, 22414, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:42', '2022-03-15 16:03:42'),
(24523, 3046, 22415, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:32', '2021-03-16 16:07:32'),
(24524, 1006, 22415, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:03:26', '2021-03-29 17:03:26'),
(24525, 9057, 22415, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:29:14', '2021-05-25 12:29:14'),
(24526, 1006, 22415, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:40', '2021-06-11 14:47:40'),
(24527, 3040, 22415, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:50:01', '2021-06-30 16:50:01'),
(24528, 1006, 22415, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:12', '2021-07-12 15:55:12'),
(24529, 1006, 22415, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:39', '2021-07-29 17:06:39'),
(24530, 1006, 22415, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:49', '2021-08-02 09:47:49'),
(24531, 1006, 22415, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:34', '2021-08-13 17:05:34'),
(24532, 1006, 22415, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-23 17:04:18', '2021-08-23 17:04:18'),
(24533, 11056, 22415, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:05:00', '2021-09-21 13:05:00'),
(24534, 11056, 22415, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:15', '2021-10-01 15:50:15'),
(24535, 11056, 22415, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:00:55', '2021-10-13 17:00:55'),
(24536, 11056, 22415, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:15', '2021-10-20 16:57:15'),
(24537, 11056, 22415, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:18', '2021-11-10 17:56:18'),
(24538, 11056, 22415, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:22', '2021-11-19 17:45:22'),
(24539, 11056, 22415, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:34', '2021-12-01 13:08:34'),
(24540, 11056, 22415, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:59', '2021-12-16 13:45:59'),
(24541, 11056, 22415, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:46', '2021-12-23 15:20:46'),
(24542, 19067, 22415, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:23:49', '2022-01-12 16:23:49'),
(24543, 19067, 22415, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:10', '2022-01-26 16:31:10'),
(24544, 19067, 22415, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:24', '2022-02-11 14:30:24'),
(24545, 19067, 22415, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:23:57', '2022-02-21 17:23:57'),
(24546, 19067, 22415, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:47', '2022-03-15 16:03:47'),
(24547, 3046, 22416, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:34', '2021-03-16 16:07:34'),
(24548, 1006, 22416, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:03:41', '2021-03-29 17:03:41'),
(24549, 9057, 22416, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:29:27', '2021-05-25 12:29:27'),
(24550, 1006, 22416, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:36', '2021-06-11 14:47:36'),
(24551, 3040, 22416, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:49:59', '2021-06-30 16:49:59'),
(24552, 1006, 22416, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:08', '2021-07-12 15:55:08'),
(24553, 1006, 22416, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:36', '2021-07-29 17:06:36'),
(24554, 1006, 22416, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:53', '2021-08-02 09:47:53'),
(24555, 1006, 22416, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:30', '2021-08-13 17:05:30'),
(24556, 1006, 22416, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-23 17:04:04', '2021-08-23 17:04:04'),
(24557, 11056, 22416, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:04:55', '2021-09-21 13:04:55'),
(24558, 11056, 22416, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:09', '2021-10-01 15:50:09'),
(24559, 11056, 22416, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:00:50', '2021-10-13 17:00:50'),
(24560, 11056, 22416, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:57:06', '2021-10-20 16:57:06'),
(24561, 11056, 22416, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:12', '2021-11-10 17:56:12'),
(24562, 11056, 22416, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:27', '2021-11-19 17:45:27'),
(24563, 11056, 22416, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:53', '2021-12-01 13:08:53'),
(24564, 11056, 22416, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:53', '2021-12-16 13:45:53'),
(24565, 11056, 22416, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:20:52', '2021-12-23 15:20:52'),
(24566, 19067, 22416, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:23:44', '2022-01-12 16:23:44'),
(24567, 19067, 22416, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:30:59', '2022-01-26 16:30:59'),
(24568, 19067, 22416, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:31:05', '2022-01-26 16:31:05'),
(24569, 19067, 22416, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:18', '2022-02-11 14:30:18'),
(24570, 19067, 22416, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:23:51', '2022-02-21 17:23:51');
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
(24571, 19067, 22416, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:53', '2022-03-15 16:03:53'),
(24572, 3046, 22417, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:07:36', '2021-03-16 16:07:36'),
(24573, 1006, 22417, NULL, '2021-04-05 00:00:00.000', 'Initiated', 'Sent following address addition request @ HumanaHoustonPD humanahoustonpd@humana.com: \"Hello,   I hope you\'re doing well, please find the attached request to add our quaternary location to our urgent care contract. Please let me know if anything else is required.   Thank you. \"', NULL, NULL, '2021-03-29 17:03:52', '2021-03-29 17:03:52'),
(24574, 9057, 22417, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello, We submitted a request for adding our quaternary location to our urgent care contract for the following group:  Group Name: Statcare Minor Emergency Clinic NPI#  1689924904 TIN# 46-0575924 Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you ', NULL, NULL, '2021-05-25 12:29:36', '2021-05-25 12:29:36'),
(24575, 1006, 22417, NULL, '2021-06-18 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Re; Demographic Change  \"Hello,  I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-11 14:47:31', '2021-06-11 14:47:31'),
(24576, 3040, 22417, NULL, '2021-07-07 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Demographic Change  \"Hello,   I hope you\'re doing well, I wanted to check in on the status of location addition for the following group and providers, their information is as follows:  Practice Name: Statcare Minor Emergency Clinic Practice Tax ID# 46-0575924 Practice NPI# 1689924904 Primary Location: 500 E CAESAR  KINGSVILLE , TX 78363 Secondary Location: 6646 S. Staples St. # 122 Corpus Christi , TX 78413 Tertiary Location: 4042 River Hill Corpus Christi , TX 78410 Quaternary Location: 3817 South Padre Island Drive Corpus Christi , TX 78415  Provider Name:Ayarzagoitia, Patrick A. Provider NPI# 1649568239  Provider Name:Capupus, Juan Miguel Provider NPI# 1891168597  Provider Name: Capupus, Mari Katrina Provider NPI# 1740517945  Provider Name: Gonzalez, Mary C Provider NPI# 1952713083  Provider Name: Mason, Traci Smith Provider NPI# 1497127831  Provider Name: Rabagos, Katherine Provider NPI# 1134415631  Provider Name: Rogers, Petina L. Provider NPI# 1801443916  Provider Name: Francis, William Robert. Provider NPI# 1457994436  Provider Name: Svatek, Maegan Provider NPI# 1639670250  Provider Name: Trevino, Rose Puentes. Provider NPI# 1437174794  Please get back to me as soon as you\'re able.  Thank you. \"', NULL, NULL, '2021-06-30 16:49:56', '2021-06-30 16:49:56'),
(24577, 1006, 22417, NULL, '2021-07-19 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   I hope you\'re doing well, I wanted to get an update regarding a demographic change request that was submitted a few months ago for the following group:  Group Name: Statcare Minor Emergency Clinic NPI# 1437174794 TIN# 46-0575924 Quaternary Location: 3817 South Padre Island Drive, Corpus Christi, TX 78415  Please get back to me as soon as possible on the status of the location addition.   Thank you. \"', NULL, NULL, '2021-07-12 15:55:05', '2021-07-12 15:55:05'),
(24578, 1006, 22417, NULL, '2021-08-05 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change  \"The group is loaded with those addresses – we do not load individual providers to your type of contract (Ancillary Contract).  Thank you  Becky Solis Network Operations Coordinator – Provider Contracting South Texas Network Management  Humana 8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied:  \"Hello,   We are still waiting for an update on this, the address is still not showing up on the provider directory. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-07-29 17:06:33', '2021-07-29 17:06:33'),
(24579, 1006, 22417, NULL, '2021-08-09 00:00:00.000', 'In Process', 'Received the following update from stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Credentialing was denied for the 3817 South Padre Island Drive, Corpus Christi, TX 78415 due to accreditation missing from the credentialing application.  Please provide the complete credentialing application along with the accreditation and I will resubmit.  Thank you Becky Solis  Network Operations Coordinator – Provider Contracting South Texas Network Management Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229 T 1.502.301.2506 F 855.461.6048 stxnm@humana.com\"  Replied: \"Hello Becky,  Please find the attached information. Do let me know if anything else is required to proceed.  Thank you.\"', NULL, NULL, '2021-08-02 09:47:56', '2021-08-02 09:47:56'),
(24580, 1006, 22417, NULL, '2021-08-20 00:00:00.000', 'In Process', 'Sent f/u email @ S TX Network Mgmt stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,  I hope you\'re doing well, I wanted to get an update regarding the status of my application.   Please get back to me as soon as possible.  Thank you.\"', NULL, NULL, '2021-08-13 17:05:25', '2021-08-13 17:05:25'),
(24581, 1006, 22417, NULL, '2021-08-30 00:00:00.000', 'In Process', 'Sent another f/u email @ stxnm@humana.com:  Sub: Demographic Change Status - RHC - Humana  \"Hello,   We are still waiting for a response on the status of our location addition request. Please get back to me as soon as possible.  Thank you. \"', NULL, NULL, '2021-08-23 17:04:01', '2021-08-23 17:04:01'),
(24582, 11056, 22417, NULL, '2021-09-28 00:00:00.000', 'In Process', 'Rep. : John M   Status : Staples location not showing on the system. She gonna escalate the request & forwarding to credentialing team. Providers are linked to Tax I.D. It is an ancillary contract. And the practice and providers are in network with humana. Just the location listing remaining.  Ref code : 2000201470702  Contact at : 800-626-2741 opt 2', NULL, NULL, '2021-09-21 13:04:49', '2021-09-21 13:04:49'),
(24583, 11056, 22417, NULL, '2021-10-08 00:00:00.000', 'In Process', 'Rep. : Anthony B  Contact at : 800-626-2741  Status : Still in processing. Properly received on 09/21/2021. Reviewing by the Provider info dept. Take 15-30 days.  Ref code. : 2000203124722', NULL, NULL, '2021-10-01 15:50:03', '2021-10-01 15:50:03'),
(24584, 11056, 22417, NULL, '2021-10-20 00:00:00.000', 'In Process', 'Email sent to :	jmarfa@humana.com & stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good evening Marfa!  Hope this email finds you well. Please provide me with the updates on my application for additional locations which I have submitted to you on 21, Sept,2021.  Have all the locations been listed under the Facility TIN & the providers?  Please respond to my query at your earliest convenience.  Thank you! Take care of yourself!', NULL, NULL, '2021-10-13 17:00:44', '2021-10-13 17:00:44'),
(24585, 11056, 22417, NULL, '2021-10-27 00:00:00.000', 'In Process', 'Email received from : stxnm@humana.com  Sub  : Re: Demographic Change Status - RHC - Humana   The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal', NULL, NULL, '2021-10-20 16:56:59', '2021-10-20 16:56:59'),
(24586, 11056, 22417, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:01', '2021-11-10 17:56:01'),
(24587, 11056, 22417, NULL, '2021-11-17 00:00:00.000', 'In Process', 'Email sent to : stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-11-10 17:56:07', '2021-11-10 17:56:07'),
(24588, 11056, 22417, NULL, '2021-11-26 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Sub : Re: Demographic Change Status - RHC - Humana  The request was received and is in the queue.     We apologize for the delay.     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com     Learn more about our Bold Goal  #MoreHealthyDays  #startwithhealthy', NULL, NULL, '2021-11-19 17:45:32', '2021-11-19 17:45:32'),
(24589, 11056, 22417, NULL, '2021-12-08 00:00:00.000', 'In Process', '	 Email received from:   stxnm@humana.com  Sub:   Enrollment Query - Statcare Minor Emergency Clinic - Humana  Hello,     Three of the five locations are currently loaded in our system.     Please complete the attached credentialing applications for the following locations:     3817 South Padre Island Drive Corpus Christi, TX 78415  2101 FM 2165, Rockport, TX 78382     Please include all required certifications, licenses, etc.     Please return to STXNM@humana.com .     Thank you,     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229  T 800-626-2741  F 855.461.6048  stxnm@humana.com', NULL, NULL, '2021-12-01 13:08:48', '2021-12-01 13:08:48'),
(24590, 11056, 22417, NULL, '2021-12-23 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Demographic Update_Interaction#2000207180578  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon Marfa!  Hope this email finds you well. Any updates on the application yet? Have all the locations been listed under the Facility TIN & the providers?  In the meantime, please do not hesitate to reach out if you have any questions or concerns.  Take Care!  Thank you! Have a wonderful day!', NULL, NULL, '2021-12-16 13:45:47', '2021-12-16 13:45:47'),
(24591, 11056, 22417, NULL, '2021-12-30 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Sub: Re: Demographic Change Status - RHC - Humana  Enrollment Query - Statcare Minor Emergency Clinic - Humana   Good afternoon!  Hope this email finds you well. Please let us know about the application submitted for listing the location under the Tax I.D and providers. Have all the locations been listed under the TIN yet or not?  Please respond to our query at your earliest opportunity.  Thank You! Have a wonderful day!', NULL, NULL, '2021-12-23 15:21:09', '2021-12-23 15:21:09'),
(24592, 19067, 22417, NULL, '2022-01-19 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||     Greetings!  Hope this email finds you well.  I would like to know the enrollment status of the following providers with the mentioned location.  Group Name	Statcare Minor Emergency Clinic Tax ID	46-0575924 Group NPI	1689924904 Location	3817 South Padre Island Drive, Corpus Christi, TX 78415 Provider Name	NPI Elsa Pearce	1083784102 Petina Rogers	1801443916 Traci Mason	1497127831 Maegan Svatek	1639670250 Patrick Ayarzagoitia	1649568239 Mari Capupus	1740517945 William Francis	1457994436 Mary Gonzalez	1952713083 Katherine Rabagos	1134415631 Juan Capupus	1891168597 Rose Trevino	1437174794   Thanks! Have a wonderful day. Hammad Ahmed.', NULL, NULL, '2022-01-12 16:23:38', '2022-01-12 16:23:38'),
(24593, 19067, 22417, NULL, '2022-02-02 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com, HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||   Greetings!  Any updates on the following request?  Kindly respond in a timely manner.  Regards, Hammad.', NULL, NULL, '2022-01-26 16:30:53', '2022-01-26 16:30:53'),
(24594, 19067, 22417, NULL, '2022-02-18 00:00:00.000', 'In Process', 'Email received from: HumanaHoustonPD@humana.com  Subject: Re: Enrollment Query || Statcare SPID || Providers || Humana ||  Since this group is not in the Houston Market, we will not be responding to this request.', NULL, NULL, '2022-02-11 14:30:12', '2022-02-11 14:30:12'),
(24595, 19067, 22417, NULL, '2022-02-28 00:00:00.000', 'In Process', 'Email sent to: stxnm@humana.com  Subject: Fwd: Enrollment Query || Statcare SPID || Providers || Humana ||   Hello!  Hope this email finds you well.  Kindly look into my request mentioned below.   Regards, Hammad Ahmed.', NULL, NULL, '2022-02-21 17:23:45', '2022-02-21 17:23:45'),
(24596, 19067, 22417, NULL, '2022-03-22 00:00:00.000', 'In Process', 'Email received from: stxnm@humana.com  Subject: Enrollment Query || Statcare SPID || Providers || Humana ||    This contract is an Ancillary contract for an Urgent Care Clinic.  We do not add individual providers to this type of contract.     Thank you        Network Operations Coordinator – Provider Contracting     South Texas Network Management  Humana  8119 Datapoint  Dr. 6th floor / San Antonio, TX 78229     F 855.461.6048  stxnm@humana.com', NULL, NULL, '2022-03-15 16:03:58', '2022-03-15 16:03:58'),
(24597, 3046, 22418, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:50', '2021-03-16 16:11:50'),
(24598, 1006, 22418, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:40', '2021-03-26 17:19:40'),
(24599, 9057, 22418, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Sent following email to facilityinfo@usamco.com Sub: Enrollment status request - RHC - Managed Care Organization  Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:48:34', '2021-05-25 12:48:34'),
(24600, 1006, 22418, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference. ', NULL, NULL, '2021-06-11 14:56:26', '2021-06-11 14:56:26'),
(24601, 3046, 22419, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:52', '2021-03-16 16:11:52'),
(24602, 1006, 22419, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:20:02', '2021-03-26 17:20:02'),
(24603, 9057, 22419, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:48:47', '2021-05-25 12:48:47'),
(24604, 1006, 22419, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:12:33', '2021-06-11 15:12:33'),
(24605, 3046, 22420, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:54', '2021-03-16 16:11:54'),
(24606, 1006, 22420, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:57', '2021-03-26 17:19:57'),
(24607, 9057, 22420, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:04', '2021-05-25 12:49:04'),
(24608, 1006, 22420, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:12:25', '2021-06-11 15:12:25'),
(24609, 3046, 22421, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:55', '2021-03-16 16:11:55'),
(24610, 1006, 22421, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:53', '2021-03-26 17:19:53'),
(24611, 9057, 22421, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:12', '2021-05-25 12:49:12'),
(24612, 1006, 22421, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:12:17', '2021-06-11 15:12:17'),
(24613, 3046, 22422, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:56', '2021-03-16 16:11:56'),
(24614, 1006, 22422, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:48', '2021-03-26 17:19:48'),
(24615, 9057, 22422, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:19', '2021-05-25 12:49:19'),
(24616, 1006, 22422, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:12:10', '2021-06-11 15:12:10'),
(24617, 3046, 22423, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:58', '2021-03-16 16:11:58'),
(24618, 1006, 22423, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:44', '2021-03-26 17:19:44'),
(24619, 9057, 22423, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:30', '2021-05-25 12:49:30'),
(24620, 1006, 22423, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:12:03', '2021-06-11 15:12:03'),
(24621, 3046, 22424, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:11:59', '2021-03-16 16:11:59'),
(24622, 1006, 22424, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:36', '2021-03-26 17:19:36'),
(24623, 9057, 22424, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:37', '2021-05-25 12:49:37'),
(24624, 1006, 22424, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:11:56', '2021-06-11 15:11:56'),
(24625, 3046, 22425, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:12:01', '2021-03-16 16:12:01'),
(24626, 1006, 22425, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:31', '2021-03-26 17:19:31'),
(24627, 9057, 22425, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:47', '2021-05-25 12:49:47'),
(24628, 1006, 22425, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:11:47', '2021-06-11 15:11:47'),
(24629, 3046, 22426, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:12:02', '2021-03-16 16:12:02'),
(24630, 1006, 22426, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:26', '2021-03-26 17:19:26'),
(24631, 9057, 22426, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:49:57', '2021-05-25 12:49:57'),
(24632, 9057, 22426, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:50:06', '2021-05-25 12:50:06'),
(24633, 1006, 22426, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:11:38', '2021-06-11 15:11:38'),
(24634, 3046, 22427, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:12:04', '2021-03-16 16:12:04'),
(24635, 1006, 22427, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:22', '2021-03-26 17:19:22'),
(24636, 9057, 22427, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:50:16', '2021-05-25 12:50:16'),
(24637, 1006, 22427, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:11:30', '2021-06-11 15:11:30'),
(24638, 3046, 22428, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:12:05', '2021-03-16 16:12:05'),
(24639, 1006, 22428, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Submitted a location addition email @ facilityinfo@usamco.com: \"Hello,   I hope you\'re doing well, we wish to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Please let me know if anything else is required to complete this request.   Thank you.\"  Once the location is added, the task will be approved as it is an ancillary contract with no need to add individual providers. ', NULL, NULL, '2021-03-26 17:19:16', '2021-03-26 17:19:16'),
(24640, 9057, 22428, NULL, '2021-06-01 00:00:00.000', 'In Process', 'Hello,   we requested to add the following locations to our facility contract, group information and the addresses are as follows:   Group name: Statcare Minor Emergency Clinic NPI# 1689924904 TIN# 46-0575924  Primary Address: 500 E Caesar Avenue, Kingsville, TX 78363  Secondary Address: 4042 River Hill, Corpus Christi, TX 78410  Tertiary Address: 6646 S. Staples St. # 122, Corpus Christi, TX 78413 Phone# 361-334-2023 Fax# 361-334-2025  Quaternary Address: 3817 South Padre Island Drive, Corpus Christi, TX 78415 Phone# 361-334-2035 Fax# 361-334-2038  Kindly let us know what is the current status regarding our request as soon as possible.  Thank you.  ', NULL, NULL, '2021-05-25 12:50:30', '2021-05-25 12:50:30'),
(24641, 1006, 22428, NULL, '2021-06-18 00:00:00.000', 'Approved', 'Received the following response from Jackie Hipolito HIPOLITJ@usamco.com:  Sub: USA Provider# 1177750 - Location Addition  \"Thank you Brad , the locations have been added effective 03/26/2021 per update recv’d.  A confirmation for your records.  Kindly USA MCO rising star Jackie Hipolito, Provider Relations USA Managed Care Organization usamco.com Austin:  P: 512.306.0201 F: 512.306.1921\"  Location addition confirmation is attached as well as executed facility contract in main group task for reference.  ', NULL, NULL, '2021-06-11 15:11:22', '2021-06-11 15:11:22'),
(24642, 3046, 22429, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:48', '2021-03-16 16:20:48'),
(24643, 1006, 22429, NULL, '2021-04-02 00:00:00.000', 'In Process', 'The request has been submitted for address addition to medicaid:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\"', NULL, NULL, '2021-03-26 15:08:47', '2021-03-26 15:08:47'),
(24644, 1006, 22429, NULL, '2021-04-02 00:00:00.000', 'Initiated', NULL, NULL, NULL, '2021-03-26 15:08:54', '2021-03-26 15:08:54'),
(24645, 1006, 22429, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:06:13', '2021-06-03 17:06:13'),
(24646, 3046, 22430, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:50', '2021-03-16 16:20:50'),
(24647, 1006, 22430, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:10:43', '2021-03-26 16:10:43'),
(24648, 1006, 22430, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:05:09', '2021-06-03 17:05:09'),
(24649, 3046, 22431, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:51', '2021-03-16 16:20:51'),
(24650, 1006, 22431, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:11:25', '2021-03-26 16:11:25'),
(24651, 1006, 22431, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:04:39', '2021-06-03 17:04:39'),
(24652, 3046, 22432, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:52', '2021-03-16 16:20:52'),
(24653, 1006, 22432, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:11:30', '2021-03-26 16:11:30'),
(24654, 1006, 22432, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:04:11', '2021-06-03 17:04:11'),
(24655, 3046, 22433, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:54', '2021-03-16 16:20:54'),
(24656, 1006, 22433, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:11:33', '2021-03-26 16:11:33'),
(24657, 1006, 22433, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:03:41', '2021-06-03 17:03:41'),
(24658, 3046, 22434, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:55', '2021-03-16 16:20:55'),
(24659, 1006, 22434, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:11:37', '2021-03-26 16:11:37'),
(24660, 1006, 22434, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference.  ', NULL, NULL, '2021-06-03 17:03:13', '2021-06-03 17:03:13'),
(24661, 3046, 22435, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:57', '2021-03-16 16:20:57'),
(24662, 1006, 22435, NULL, '2021-04-02 00:00:00.000', 'Initiated', 'Location addition request submitted to Medicaid, need to attach providers after location has been added:  \"Portal Ticket #	Application Name	NPI	Status Update Date	Transction Type	Status	Messages	Available Action   17675950	PIMS Address		3/26/2021	Provider Information Change (PIC) Form	In Progress	View\" ', NULL, NULL, '2021-03-26 16:11:42', '2021-03-26 16:11:42'),
(24663, 1006, 22435, NULL, '2021-06-10 00:00:00.000', 'Approved', 'The location has been added. Location confirmation is attached for reference. ', NULL, NULL, '2021-06-03 17:02:34', '2021-06-03 17:02:34'),
(24664, 3046, 22436, NULL, NULL, 'New/Not Initiated', NULL, NULL, NULL, '2021-03-16 16:20:59', '2021-03-16 16:20:59');
