Indiana Opt Out List

Indiana Opt Out List Specialty Last Name, First Name Street Address City-State-Zip NPI Effective Date End Date 01 Davis, DO,Thomas,M. 8 N Grant Street Brownsburg, IN 46112-1223 12068438 10/01/98 09/30/2018 01 Elliot,MD,Stephen,P 05 Lindsey,MD,John,D. 05 Satkamp, MD Brett 179 Fishers Crossing Drive Fishers, IN 46038-2778 1437160256 10/01/2015 09/30/20 1004 Parkway Ave Suite C Elkhart, IN 46516-9349 1679537443 06/11/2014 06/10/2018 1500 W Oak St Ste 100 Zionsville, IN 46077-1827 1093979114 12/01/2016 11/30/2018 07 Swan, MD Lori S 2020 Union St Ste 300 Lafayette, IN 47904-2694 1518044601 07/01/2017 06/30/20 08 Brengle, MD Blair 08 9002 N Meridian Street Suite 107 Indianapolis, IN 46260-5349 1023014420 10/01/2017 09/30/20 Burkholder, MD Susan, E. 703 Pro-Med Lane Carmel, IN 46032-5317 1750457974 07/15/2016 07/14/2018 08 DeWester,MD,Jeffrey,N 6447 N East Street, Suite C Indianapolis, IN 46227-21 1649244450 09/08/2016 09/08/2018 08 Gladd,MD,Jeffrey,E. 4930 Illinois Road Fort Wayne, IN 46814-5105 1780685768 08/01/2010 07/31/2018 08 Guyer, Leonard Dale 836 E 86th St Indianapolis, IN 46240-1806 1407072325 07/25/2017 07/24/20 08 Hector,MD,Andrew,R. 533 E. County Line Road Greenwood, IN 46143-1073 18141875 01/01/2014 12/31/2017 08 Leazenby, MD Erica 1200 W Carmel Dr Carmel, IN 46032-8707 1093708380 01/01/2017 01/01/20 10/26/2017 www.wpsgha.com Page 1 of 21

08 Lentz,MD,Kimberly,J 1500 W Oak Street, Suite 500 Zionsville, IN 46077-1852 1851374961 07/10/2012 07/09/2018 08 Laborsky,MD,Melissa,A 7771 Spring Mill Road Indianapolis, IN 46260-3637 72771517 09/25/2014 09/24/2018 08 Maxwell Pflieger, DO, Janelle 225 Hauenstein Road Huntington, IN 46750-8803 1821210766 08/14/2016 08/13/2018 08 Morris, Amanda, MD 08 Morris, MD, Brian Francis 08 Olp, MD Ashlie 08 Patel, MD Risheet 13914 Southeastern Pkwy Ste 208 Fishers, IN 46037-7125 1316969579 08/15/2016 08/15/2018 13914 Southeastern Parkway Suite 208 Fishers, IN 46037-7125 1659393825 10/01/2016 09/30/2018 9002 N Meridan Street Suite 107 Indianapolis, IN 46260-5349 12903915 10/01/2017 09/30/20 9780 Lantern Rd Ste 370 Fishers, IN 46037-4093 1841216629 05/01/2017 04/30/20 08 Pflieger, DO Matthew 225 Hauenstein Rd Huntington, IN 46750-8803 1184770703 08/28/2017 08/27/20 08 Priddy, MD Matthew Jay 08 08 8333 Naab Road Suite 360 Indianapolis, IN 46260-83 1265575708 07/11/2017 07/10/20 Rader, DO Sarah Lynley 1503 W Oak St Zionsville, IN 46077-1840 12223504 10/01/2017 09/30/20 Schmidt,MD,Jonathan,P. 8333 Naab Road, Suite 360 Indianapolis, IN 46260-83 14970755 07/29/2013 07/28/20 08 Selio, MD, Brigitte 53800 Generations Dr South Bend, IN 46635-1543 1710325386 10/03/2016 10/02/2018 08 Stoller,MD,Harry,J. 08 Szewczyk, MD Emily Kae 8604 Allisonville Rd, Ste 220 Indianapolis, IN 46250-1546 1003887498 11/01/2009 10/31/2017 8333 Naab Road Ste 360 Indianpolis, IN 46260-83 1689657553 07/11/2017 07/10/20 10/26/2017 www.wpsgha.com Page 2 of 21

08 09 Turner, MD, Robert Charles Murphy, MD James Patrick 10 Gupta, MD, Rakesh K 11 Busk,MD,Michael,F. 11 11 Fraser, MD Shelagh Anne 3554 Promenade Parkway Suite H Lafayette, IN 47909-8418 1144372863 11/02/2016 11/01/2018 720 Rolling Creek Drive Suite 100 New Albany, IN 47150-7284 1275523979 07/01/2017 06/30/20 1501 Wabash Street, Ste 303 Michigan City, IN 46360-4355 1285704494 04/14/2016 04/13/2018 8333 Naab Road, Suite 301 Indianapolis, IN 46260-83 15987170 04/01/2014 03/31/2018 8333 Naab Road Suite 360 Indianapolis, IN 46260-83 1003934605 07/11/2017 07/10/20 Hart- Cavallo,MD,Susan,R 53800 Generations Dr South Bend, IN 46635-1543 1649261710 03/05/2013 03/04/20 11 Logan,MD,Kevin,M. 8499 Fishers Center Drive Fishers, IN 46038-2318 1639384183 04/01/2013 03/31/20 11 Murphy, DO, Derek 13578 E 131st Street Fishers, IN 46037-6401 16014628 06/27/2016 06/26/2018 11 Veatch, MD Steven Craig 8333 Naab Road Ste 360 Indianapolis, IN 46260-83 1407830391 07/11/2017 07/10/20 12 Feeney,DO,Tamzon,D. 2204 West 58th Street Indianapolis, IN 46228-1712 1225238603 07/18/2013 07/17/20 16 Cavallo,MD,Uthman, 16 Reynolds, DO, Lynnova 53760 Generations Drive South Bend, IN 46635-1539 1528013372 07/17/2015 07/16/20 755 Carmel Dr Suite 212 Carmel, IN 46032-5878 1164424792 10/01/2017 09/30/20 Adams, DDS, Benjamin H. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 1154357978 08/10/2017 08/09/20 Adams,DDS,Timothy,C. 1040 North Range Line Rd. Suite B Carmel, IN 46032-1470 1760601405 02/23/2016 02/22/2018 10/26/2017 www.wpsgha.com Page 3 of 21

Adams, DDS, Joseph B. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 12269572 08/10/2017 08/09/20 Adams, DDS, William R. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 1700826393 08/14/2017 08/13/20 Allen,DDS,Ronald, 9524 E Washington St Indianapolis, IN 46229 1255421715 01/01/2016 12/31/2017 Ancich,DDS,John, 1802 Robinhood Blvd Ste 1 Schereville, IN 46375-1845 1538237979 09/12/2015 09/11/20 Angelo,DDS,Robert,S 221 Medical Plaza Michigan City, IN 46360-3364 1477661049 07/15/2015 07/14/20 Anglis,DDS,Leonard,F. 1549 S Court St Crown Point, IN 46307-4809 1447390885 02/02/2016 02/01/2018 Arnold,DDS,Eric,J 2206 N Wheeling Avenue Muncie, IN 47303-1633 1073660148 01/13/2015 01/12/20 Awadallah,DDS,Iyad, 1613 East 80th St Merriville, IN 46410-5737 1124313838 09/21/2015 09/21/20 Ayers, DMD, Haviland, J. 202 E 17th Street Huntingburg, IN 47542-9565 1316399959 08/01/2016 07/31/2018 Bagnoli,DDS,Michael,L. 2020 Union Street, Suite 200 Lafayette, IN 47904-2694 17009767 10/20/2014 10//2018 Bamesberger, DDS, Larry, George 3223 Heavilin Rd Valparaiso, IN 46385-7300 1023128899 04/14/2016 04/13/2018 Bendush,DDS,Bradley, Benson,DDS,Dawn,J 115 N Shortridge Rd Ste 200 Indianapolis, IN 462-4917 62510610 10/15/2015 10/14/20 7810 W Jefferson Boulevard fort Wayne, IN 46804-4138 1790862027 09/17/2015 09/16/20 Bianco,DDS,Ruoy, 165 W University Dr Mishawaka, IN 46545-19 1730268814 12/01/2015 11/30/2017 10/26/2017 www.wpsgha.com Page 4 of 21

Biggs,DDS,Jeffery,C. 9333 N Meridian Street, Suite 301 Indianapolis, IN 46260-1825 1720097835 07/01/2014 06/30/2018 Blanchard,DDS,Steven, B 1121 W Michigan St Indianapolis, IN. 46202-5211 1760496954 01/01/2016 12/31/2017 Bly,DDS,Phillip,M. Bringas,DDS,Josef, 7126 N Shadeland Ave Suite B Indianapolis, IN 46250-2020 1083715353 01/01/2016 12/31/2017 3750 Guion Road, Suite 280 Indianapolis, IN 46222-1695 1215117452 03/17/2014 03/16/2018 Brown,DDS,Justin,D. 5 Logan Street Peru, IN 46970-1642 1013110568 12/01/2015 12/01/2017 Bryan,DDS,Norman,E. 505 Vistula Street Elkhart, IN 46516-2809 1013082627 07/31/2013 07/30/20 Campbell,DDS,Tyrus,W. 931 E 86th St Suite 207 Indianapolis, IN 46240-1852 17504404 12/17/2015 12/16/2017 Cloyd,DDS,G Thomas, 1792 E State Rd 163 Clinton, IN 47842 1477613925 01/01/2016 12/31/2017 Combs,DDS,Julie,L. Cooper,DDS,Craig,D. 120 W. Mckenzie Rd Suite J Greenfield, IN 46140-1072 14056697 03/01/2016 02/28/2018 7265 N Shadeland Ave Indianapolis, IN 46250-2021 1740448513 03/01/2016 02/28/2018 Cornils- Golliher,DDS,Ashley, 449 E Main Street Hagerstown, IN. 47346-1337 1295870855 01//2016 01/18/2018 Crider,DDS,Kristin, Day,DDS,Rachel,A 1003 W McGalliard Rd. Muncie, IN. 47303-1768 1255710836 01/01/2016 12/31/2017 150 Professional court, Suite A Lafayette, IN 47905-5153 1144299298 05/01/2015 04/30/20 Dellinger, DDS, Aron E 1120 E Dupont Road Fort Wayne, IN 46825-1556 52415325 01/10/2017 01/09/20 10/26/2017 www.wpsgha.com Page 5 of 21

Dragoo,DDS,Joel,R. 2020 Union Street, Suite 200 Lafayette, IN 47904-2694 1780824433 10/20/2014 10//2018 Friedman,DDS,Gary, 20 Airport Rd Ste 1100 Brownsburg, IN 46112-20146 1437348752 09/22/2015 09/21/20 Geyman,DDS,Bethany,J Giesler, DDS, Nicholas W. 4450 Weston Pointe Dt Ste 100 Zionsville, IN 46077-7207 1558498238 08/31/2015 08/30/20 671 3rd Avenue Suite D Jasper, IN 47546-3653 14167007 06/15/2016 06/14/2018 Gillum,DDS,Richard,S 1259 N State Rd 135 Greenwood IN 46142-1033 62554204 09/01/2015 08/31/20 Golding,DDS,Joseph,E 3240 Middle Road Columbus, IN 47203-4426 1164538237 07/07/2015 07/06/20 Gomes,DDS,Daniel, 8235 Country Village Dr Indianapolis, IN. 46214 42358007 01/01/2016 12/31/2017 Gooding,DDS,Brittany, 1792 E State Rd 163 Clinton, IN 47842-7327 1023392347 01/01/2016 12/31/2017 Goodpaster,DDS,James, 3800 Industrial Blvd Bloomington, IN 47403-5139 1295025112 09/30/2015 09/29/20 Gossweiler,DDS,Timoth y,k 14904 Greyhound Court Carmel, IN 46032-1091 1417176934 07/01/2015 06/30/20 Greco,DDS,Brandy, 800 First Ave Evansville, IN 47710-38 1740416882 02/24/2016 02/23/2018 Guthrie,DDS,Thomas,J 5 W Logan Street Peru, IN. 46970-1642 1710082409 12/01/2015 11/30/2017 Guzek,DDS,David,V. 3465 Airport Road Portage, IN 46368-5107 1457457368 11/17/2010 11/16/2018 Haley,DDS,Sharon,M 1036 W Jefferson Street Franklin, IN. 46131-2123 1295946267 02/09/2016 02/08/2018 10/26/2017 www.wpsgha.com Page 6 of 21

Hansen,DMD,Vincent,J. Hart, DDS, William R. 9333 N Meridian Street, Suite 301 Indianapolis, IN 46260-1825 1750638664 07/01/2014 06/30/2018 10655 State Road #662 Newburgh, IN 47630-8845 1083874812 06/01/2016 05/31/2018 Hertig,DDS,Adam,R 4341 Flagstaff Cove Fort Wayne, IN 46815-4400 1720425010 07/01/2015 06/30/20 Holm,DDS,Steven, 3465 Airport Road Portage, IN 46368-5107 1346346111 11/17/2010 11/16/2018 Hornaday,DDS,Anthony, J. 620 S Tillotson Avenue Muncie, IN 47304-4448 1407897523 07/01/2012 06/30/2018 Hornaday,DDS,James, 620 S Tillotson Ave. Muncie, IN. 47304 12929753 01/01/2011 12/31/2018 Issa,DDS,Yasir, 7102 N Keystone Avenue Indianapolis, IN 46240-3242 1053753061 06/01/2015 05/30/20 James,DDS,John,P 3412 Klondike Road West Lafayette, IN 47906-5218 1538271291 07/01/2015 06/30/20 Jacobs, DDS, Jordon C. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 1245644285 08/14/2017 08/13/20 John, DDS Vanchit 3750 Guion Rd #280 Indianapolis, IN 46222-1696 17907291 08/16/2017 08/15/20 Johnson,DDS,Arthur,D 1202 W Buena ivsta, Suite 206 Evansville, IN 47710-5134 1861441503 05/15/2015 05/14/20 Jones,DDS,Heath,W. 3725 Rome Dr Suite A Lafayette, IN 47905-4490 1366532079 01/01/2016 12/31/2017 Kenfield,DDS,Melissa, 9247 Broadway Ste C Merrillville, IN 46410-7093 1033237086 11/02/2015 11/01/2017 Ketcham,DDS,Robert,L. 1120 E DuPont Road Fort Wayne, IN 46825-1556 1841317518 10/01/2014 09/30/2018 10/26/2017 www.wpsgha.com Page 7 of 21

Kinney, DDS, Chris D. 3825 Fairview Drive Anderson, IN 46013-4059 1003978586 10/01/2012 09/30/2018 Klauer,DDS,Daniel,G. 17901 Turners Drive South Bend, IN 46635-1529 1740592179 09/11/2013 09/10/20 Kolb,DDS,David,R 137 E Morton Street Oakland city, IN 47660-18 1386668671 07/01/2015 06/30/20 Kroczek,DDS,Catherine, 2025 West Glen Park Ave Griffith, IN 463--3704 1245456441 12/17/2015 12/16/2017 Lau, DDS, Kenneth U 210 E Water ST Pendleton, IN 46064-1047 1013002310 04/18/2016 04/17/2018 Lee,DDSAshley, 411 Clifty Dr Madison, IN 47250-1607 32460029 12/01/2015 11/30/2017 Ley, DDS, Paul J. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 92954457 08/10/2017 08/09/20 Lipton,DDS,James,M. 9000 Cline Avenue Highland, IN 46322-2204 1174562771 11/04/2016 11/04/2018 Lutz,DDS,James,E. 3725 Rome Dr Suite A Lafayette, IN 47905-4490 1770997215 01/01/2016 12/31/2017 Macri,DDS,James,V 5156 Bittersweet Road Granger, IN 46530-0859 1063436608 06/17/2015 06/16/20 Mahan, DDS Vanessa 710 Averitt Rd Ste D Greenwood, IN 46143-6391 1437247608 04/13/2017 04/12/20 Mahler,DDS,Thomas, 165 W University Dr Mishawaka, IN 46545-19 1699900845 12/01/2015 11/30/2017 Mahoney,DDS,Terrance,P. 17901 Turners Drive South Bend, IN 46635-1529 1780740084 09/11/2013 09/10/20 Marrs,DDS,Lucas, 6535 E 82nd St Suite 211 Indianapolis, IN 46250-45 18717558 02/01/2016 01/31/2018 10/26/2017 www.wpsgha.com Page 8 of 21

Marszalek,DDS,Laura, 2628 Western Avenue Connersville, IN 47331-1803 1851513311 12/01/2015 11/30/2017 Martinsen,DDS,Scott,W 1011 Michigan Avenue Laporte, IN 46350-3584 1396785572 01/01/2015 12/31/2018 Martinsen,DDS,Valerie, R. 1011 Michigan Avenue Laporte, IN 46350-3584 1003017005 01/01/2015 12/31/2018 Mcquinn,DDS,Jeffrey,M. 650 Fairgrounds Rd Tipton, IN 46072-8599 1063773463 01/21/2016 01/20/2018 McQuinn,DDS,Kassey,J. 650 Fairgrounds Road Tipton, IN 46072-8599 1659523538 01/25/2016 01/24/2018 Mcquinn,DDS,Mark,A. 650 Fairgrounds Rd Tipton, IN 46072-8599 1508956574 01//2016 01/18/2018 Middaugh,DDS,Glen, 5404 E Bill Farr Drive Terre Haute, IN 47803-9321 1053316901 09/23/2015 09/22/20 Montefalco, DDS, Amy Nowakowski,DDS,Allan, R Ogle, DDS, David G. 303 North Alabama St, Ste 270 Indianapolis, IN 46204-2152 18842993 05/01/2016 04/30/2018 3701 N Everbrook Lane Muncie, IN 47304-5270 1306978937 07/01/2014 06/30/2018 10655 State Road #662 Newburgh, IN 47630-8845 14882340 06/01/2016 05/31/2018 Orr, DDS Katherine E 5430 E 86th St Indianapolis, IN 46250-1553 1881704617 03/24/2016 03/23/2018 Pete, DDS Joseph 710 Averitt Rd Ste D Greenwood, IN 46143-6391 1013010446 04/13/2017 04/12/20 Pfotenhauer, DDS, David H. 8102 Kingston St #500 Avon, IN 46123-9594 1548201171 08/15/2017 08/14/20 Phelps,DDS,Jason,M. 1003 W. Mcgalliard Rd Muncie, IN 47303-1768 1841323896 12/22/2015 12/21/2017 10/26/2017 www.wpsgha.com Page 9 of 21

Phillips,DDS,Gregory, 3180 Middle Dr Columbus, IN 47203-2298 1417022427 12/15/2015 12/14/2017 Ploeger, DDS, Amy Meyer Poulsen,DDS,William,B 8788 S State Rd 109 Box 1 Knightstown, IN 46148-9592 1578637872 06/01/2016 05/31/2018 2709 Washington Avenue Evansville, IN 47714-2411 1124233101 05/29/2015 05/28/20 Pumphrey,DDS,Jeffrey, R. 311 N Broadway St Seymour, IN 47274-1709 1225136088 02/01/2016 01/31/2018 Rector,DDS,Thomas,C 1003 E McGalliard Rd. Muncie, IN. 47303-1768 1346229358 01/01/2016 12/31/2017 Reef,DDS,Scott,A 415 N 26th Street, Suite 303 Lafayette, IN 47904-2893 1730252305 11/01/2007 10/31/2017 Rexford, DMD, Ashleigh M. 3750 Guion Rd #280 Indianapolis, IN 46222-1696 1306072814 08/15/2017 08/14/20 Rheinlander,DDS,Ronal d, 2229 W Virginia St Evansville, IN 47712-5214 1639173503 09/30/2015 09/29/20 Roberts,DDS,John,R 724 N Grand Ave Connersville IN 47331-2015 1285799395 12/31/2015 12/30/2017 Sadler, Jr,,DDS,Charles, 121 Lakeside Dr Fishers, IN 46038-1316 1285882589 09/23/2015 09/23/20 Salkeld,DDS,Steven, 10540 Coldwater Rd Fort Wayne, IN 46845-1268 1851353601 09/14/2015 09/13/20 Schaefer,DDS,James,J. Schmitz, DDS, Samuel Edward 135 N Shortridge Rd Suite A1 Indianapolis, IN 462-8905 1265500367 12/17/2015 12/16/2017 10655 State Road #662 Newburgh, IN 47630-8845 11545881 06/01/2016 05/31/2018 Schymik,DDS,Mark, 800 First Ave Evansville, IN 47710-38 15280940 02/24/2016 02/23/2018 10/26/2017 www.wpsgha.com Page 10 of 21

Shock,DDS,David, 14139 Town Center Blvd #200 Noblesville, IN. 46060-3368 1174787865 01/15/2016 01/14/2018 Schroeder,DDS,Geralyn, 8028 E 10th St Ste C Indianapolis, IN 462-5243 1104003466 10/01/2015 09/30/20 Schroeder,DDS,Miles, 8028 E 10th St Ste C Indianapolis, IN 462-5243 1447397765 10/01/2015 09/30/20 Sergio,DDS,Paul,A. 18 Edison Road South Bend, IN 46617-1711 22174432 04/20/2009 04//20 Shambaugh,DDS,Jeffre y,j 4341 Flagstaff Cove Fort Wayne, IN 46815-4400 1811080948 07/01/2015 06/30/20 Shattuck,DDS,Lori, 1035 W Jefferson St Franklin, IN 46131-2123 1164696357 02/04/2016 02/03/2018 Shaw, DDS Chad 1409 N Michigan St Plymouth, IN 46563-11 1508873894 01/01/2017 01/01/20 Shoemaker,DDS,Debor ah 2310 Allison Lane Jeffersonville, IN 47130-58 1245491042 10//2011 10/18/2017 Sitzman, DDS Mark Sondhi,DDS,Anoop, Souers,DDS,James,M 320 W Buena Vista Road Evansville, IN 47710-3715 1124126693 10/26/2016 10/26/2018 9333 N Meridian St, Ste 301 Indianapolis, IN 46260-1825 1427067545 07/01/2012 06/30/2018 4140 South Emerson Ave. Beech Grove, IN. 46107-2426 1699802439 12/01/2015 11/30/2017 Stapp,MD,Emily, 1572 Plank Rd Jeffersonville, IN 47130-4250 1811069081 01/01/2016 12/31/2017 Steckbeck, DDS, Thomas J 8007 South Merdian St Indianapolis, IN 46217-2922 92887442 03/31/2016 03/31/2018 Steed,DDS,Pamela,A. 8402 Harcourt Road, Ste 724 Indianapolis, IN 46260-2056 1851466361 04/01/2004 03/31/2018 10/26/2017 www.wpsgha.com Page 11 of 21

Steffey,DDS,Christian,M. 2020 Union Street, Suite 200 Lafayette, IN 47904-2694 1104920453 10/20/2014 10//2018 Terry,DDS,Scott,A 501 Henry Street North Vernon, IN 47265-1057 1366476830 08/01/2015 07/31/20 Thompson,DDS,Nell, 1035 W Jefferson St. Franklin, IN. 46131-2123 1104037175 02/04/2016 02/03/2018 Tiek, DDS Brandon 14390 Clay Terrace Blvd Ste 249 Carmel, IN 46032-3668 1780754960 11/17/2016 11/17/2018 Tromley, DDS, Patrick A 431 Main Street Evansville, IN 47708-1501 1124099759 06/01/2016 05/31/2018 Troutman, DDS, Kenneth R. 202 E 17th Street Huntingburg, IN 47542-9565 1225046592 08/01/2016 07/31/2018 Turner,DDS,Veronica, 3280 Middle Road Columbus, IN 47203-4426 1346552379 01/12/2016 01/11/2018 Wiland,DDS,Bruce,B Willison, DMD, Tracey Tabor 5162 E Stop 11 Road Suite 2 Indianapolis, IN. 46237-8618 1740225556 10//2015 10/18/2017 303 North Alabama St, Ste 270 Indianapolis, IN 46204-2152 1578678736 05/01/2016 04/30/2018 Wolf, DDS Michael 320 W Buena Vista Rd Evansville, IN 47710-3715 1437257904 10/26/2016 10/25/2018 20 Phillips, MD Frank 9200 Calumet Ave Suite 300 Munster, IN 46032-5480 1013996701 02/01/2017 01/31/20 20 Sasso,MD,Rick, 13225 N Meridian St Carmel, IN 46032-5480 16072956 11/01/2013 10/31/2017 20 Singh, MD Kern 24 Aker,MD,John,S. 9200 Calumet Ave Suite 300 Munster, IN 46321-2885 1497734289 02/01/2017 01/31/20 11450 N Meridian Street, Suite 225 Carmel, IN 46032-4689 1376676098 03/31/2015 03/30/20 10/26/2017 www.wpsgha.com Page 12 of 21

24 Galante,MD,Gustavo,E. 24 322 Indianapolis Boulevard, Suite 103 Schererville, IN 46375-4203 1073736237 01/01/2015 12/31/2018 Plantis, Jr, MD, James M. 210 E 86th Place Merrillville, IN 46410-6258 1073554143 09/29/2016 09/28/2018 24 Sando,MD,William,C 25 Johnson,MD,David,W. 26 11450 N Meridian Street, Suite 225 Carmel, IN 46032-4687 1831220938 03/31/2015 03/30/20 1146 Washington Square Mall Evansville, IN 47715-6809 02836174 01/01/2016 12/31/2017 Bojrab,MD,Christopher, D. 703 Pro Med Lane Carmel, IN 46032-5317 1689659013 01/01/2014 12/31/2017 26 Cady, Louis, MD 4727 Rosebud Lane Ste F Newburgh, IN 47630-9367 1053454413 05/01/2016 05/01/2018 26 Butler,MD,Jonathan, 703 Pro Med Lane Carmel, IN 46032-5317 1386753325 01/01/2014 12/31/2017 26 Dong,MD,Beili, 703 Pro-Med Lane Carmel, IN 46032-5317 1225269186 01/01/2016 12/31/2017 26 Esch,MD,Brian,K. 218 W Washington Street, Suite 430 South Bend, IN 46601-1708 1053405779 10/01/2010 09/30/2018 26 Flaningham,MD,Tyler,C. 703 Pro Med Lane Carmel, IN 46032-5317 1538369053 01/01/2014 12/31/2017 26 Hinchman,DO,Kearn,D. 26 Hwang,MD,Kara,Z. 53779 Generations Drive, Suite 1 south Bend, IN 46624-1576 1134206576 10/31/2013 10/30/2017 11650 Lantern Rd Ste 209 Fishers, IN 46038-3100 1508157389 01/01/2012 12/31/2017 26 Irick,MD,Shiela,L. 703 Pro Med Lane Carmel, IN 46032-5317 1518184803 01/01/2016 12/31/2018 26 Knapp, DO, Jennifer, Shirck 2955 McKinley Ave Suite C South Bend, IN 46615-2733 1700090677 08/25/2016 08/24/2018 10/26/2017 www.wpsgha.com Page 13 of 21

26 Konkle,MD,Amy,D 26 Landy,MD,Mary,J 8 E 64th Street, Suite 220 Indianapolis, IN 46220-1695 1386831865 08/04/2003 08/03/20 8803 N Meridian Street, Suite 185 Indianapolis, IN 46260-5300 1154411387 07/20/2015 07//20 26 Mishra,MD,Sanjay, 703 Pro Med Lane Carmel, IN 46032-5317 1144204751 01/01/2014 12/31/2017 26 Peters,MD,Jayanthi, 703 Pro-Med Lane Carmel, IN 46032-5317 1073638227 01/01/2016 12/31/2017 26 Posey,MD,David,J. 26 Posey,MD,Kerrie,L. 9106 N Meridian Street, Suite 210 Indianapolis, IN 46260-80 1023055894 05/28/2010 05/27/2018 9106 N Meridian Street, Suite 210 Indianapolis, IN 46260-80 1609088210 04/04/2014 04/03/2018 26 Rapinchuk,MD,Jane, 703 Pro Med Land Carmel, IN 46032-5317 1730286451 01/01/2014 12/31/2017 26 Ricke,MD,Amy,K. 703 Pro Med Lane Carmel, IN 46032-5317 1275790503 01/01/2014 12/31/2017 26 Shoot,MD,James,L. 703 Pro Med Lane Carmel, IN 46032-5317 1265416051 01/01/2014 12/31/2017 26 Troy,MD,Benjamin, 26 Waldo, MD, Ralph 26 230 E Day Road Suite 160 Mishawaka, IN 46545-3463 1144337791 10/27/2015 10/26/2017 11350 N Meridian Street #220 Carmel, IN 46032-4528 1760405963 05/11/2017 05/10/20 Webber, MD, Michael, A. 703 Pro-Med Lane Carmel, IN 46032-5317 11147613 07/15/2016 07/14/2018 30 Richmond, MD, Bruce 37 Andary,MD,Katherine, 9801 Fallcreek Rd, Ste 327 Indianapolis, IN 46256-4802 1558305748 03/30/2016 03/29/2018 9801 Fall Creek Rd #327 Indianpolis, IN 46256-4802 1508186750 06/01/2015 05/31/20 10/26/2017 www.wpsgha.com Page 14 of 21

37 Aull, MD Edward 13450 North Meridian St Ste 354 Carmel, IN 46032-1486 22009786 04/07/2016 04/06/2018 41 Embree,OD,Rodney,C 1710 Apple Glen Blvd Fort Wayne, IN. 46804-1725 1457464794 12/01/2015 11/30/2017 41 VanHoy,OD,Mary,W. 50 Barile,NP,Karen,B. 50 50 Bledsoe, NP Branden Allen 9302 N Meridian Street Indianapolis, IN 46260-1841 72683514 06/24/2014 06/23/2018 4930 Illinois Road, Suite C1 Fort Wayne, IN 46835-5105 1407890411 10/01/2010 09/30/2018 300 Spring Street Ste 3B Jeffersonville, IN 47130-3498 1184907099 10/01/2017 09/30/20 Bykowski,APRN,Debora h, 703 Pro-Med Lane Carmel, IN 46032-5317 1366883498 01/01/2016 12/31/2017 50 Doggett, ANP, Karen R. 720 Rolling Creek Drive Suite 100 New Albany, IN 47150-7284 11341951 07/01/2017 06/30/20 50 Gladd,FNP,Neely 4930 Illinois Road Fort Wayne, IN 46814-5105 1043321672 10/01/2010 09/30/2018 50 Hancock, NP, Holly M 7855 S emerson Ave, Ste H Indianapolis, IN 46237-8668 1477984490 04/01/2016 03/31/2018 50 Jungemann, NP Nancy 703 Pro-Med Lane Carmel, IN 46032-5317 1528345477 02/01/2017 01/31/20 50 Langeloh,FNP,Paula, 695 N Opportunity Dr. Columbia City, IN. 46725-1041 1164785309 10/30/2015 10/29/2017 50 Luking, NP Carissa 903 N 7th St Vincennes, IN 47591-3107 14152231 07/01/2017 06/30/20 50 Miller,APRN,Randee, 8424 Naab Road, Suite 3P Indianapolis, IN. 46260-75 1285650036 09/01/2015 08/31/20 50 Mundy,NP,Beth,A 157 Teke Burton Drive Mitchell, IN 47446-1208 1457301020 09/01/2015 08/31/20 10/26/2017 www.wpsgha.com Page 15 of 21

50 Owen Jennifer, NP 304 W HOWE ST Bloomington, IN 47403-2347 82969432 10/27/2016 10/27/2018 50 Riewe, NP, Cheryl 53800 Generations Dr South Bend, IN 46635-1543 42698402 04/26/2017 04/25/20 50 Sauer, NP Julie 50 Winet,NP,Elisabeth,F. 68 Barnhill,PhD,Laurence, R. 53800 Generations Drive South Bend, IN 46635-1534 1699207530 04/10/2017 04/09/20 4609 Grape Road, Suite 07B Mishawak, IN 46545-8258 1417956459 10/28/2013 10/27/2017 205 N College Ave, Ste 614 Bloomington, IN 47404-3956 1295763233 03/12/2013 03/11/20 68 Bigelow,PhD,Nirav,O. 703 Pro Med Lane Carmel, IN 46032-5317 1801860903 01/01/2014 12/31/2017 68 Bradley, PsyD Jennifer E. 205 N College Ave Suite 514 Bloomington, IN 47404-3952 1326250184 06/08/2017 06/07/20 68 Brothers,PhD,Andrew,J. 703 Pro Med Lane Carmel, IN 46032-5317 1780636324 01/01/2014 12/31/2017 68 Brown,PhD,Lisa,B 68 Christy, PSYD Pamela 68 68 Corning, Alexandra, PHD Cummings, PhD, Jennifer 6284 Rucker Rd Suite N Indianapolis, IN. 46220 1023148277 10/30/2015 10/29/2017 70 E 91ST STREET STE 210 Indianapolis, IN 46240*1564 1134263494 07/13/2016 07/12/2018 1251 N Eddy St Ste 200 South Bend, IN 46617-1478 1346697000 09/23/2016 09/23/2018 3625 Park Place West Suite 150 Mishawaka, IN 46545-3565 1093774630 07/15/2016 07/14/2018 68 Dalton,PsyD,Victoria,B. 703 Pro Med Lane Carmel, IN 46032-5317 1689647117 01/01/2014 12/31/2017 68 Essig, PhD, Gregory 3625 Park Place West Suite 150 Mishawaka, IN 46545-3565 1164702924 03/06/2017 03/05/20 10/26/2017 www.wpsgha.com Page 16 of 21

68 Feathergill,PhD,Jeffrey, T 68 Henein, PSYD Nandy 68 Hinkle,PhD,Linda,K 3625 Park Place West Suite 150 Mishawaka, IN. 46545-3565 82632329 01/01/2012 12/31/2017 70 E 91ST STREET STE 210 INDIANAPOLIS, IN 46240-1564 1053732404 07/13/2016 07/12/2018 13295 Illinois Street, Suite 321 Carmel, IN 46032-3022 1386630887 10/01/2015 09/30/20 68 Jeffries,PhD,Robert,W. 703 Pro Med Lane Carmel, IN 46032-5317 1669456356 01/01/2014 12/31/2017 68 Jones,PhD,Richard,H. 703 Pro Med Lane Carmel, IN 46032-5317 1790760189 01/01/2014 12/31/2017 68 Kennedy,PsyD,Mary,M. 7 Napoleon Street Valparaiso, IN 446383-4725 12162553 12/01/2013 12/31/2017 68 Kroin, PHD Loretta 68 Lokken, PhD, Cami R 68 Magnus, PSYD Keith 9292 North Meridian Street Ste 311 Indianapolis, IN 46260-1828 1780894139 04/01/2011 03/31/20 3925 East Hagan St, Ste 203 Bloomington, IN 47401-8649 1659348936 03/22/2016 03/21/2018 70 E 91ST STREET SUITE 120 Indianapolis, IN 46240-1564 1629085717 07/13/2016 07/12/2018 68 Miracle, Louise, PSYD 2525 W Vernal Pike Bloomington, IN 47404-2782 1477579290 08/30/2016 08/30/2018 68 Taylor McGee,EDD,Debra, 320 N Meridian St Ste 814 Indianapolis, IN 46204-1731 1710104633 12/01/2015 11/30/2017 68 Ridel,PsyD,Stephanie,V. 703 Pro Med Lane Carmel, IN 46032-5317 1750697769 01/01/2014 12/31/2017 68 Sexton- Villalta,PhD,Camille, 703 Pro Med Lane Carmel, IN 46032-5317 1639153455 01/01/2014 12/31/2017 68 Sipes,PhD,Gregory,P. 703 Pro Med Lane Suite 200 Carmel, IN 46032-5317 1760466569 11/03/2009 11/02/2017 10/26/2017 www.wpsgha.com Page 17 of 21

68 Stote,PhD,Joseph,J. 1618 Northbrook Drive Indianpolis, IN 46260-2755 1073599494 05/17/2014 05/16/2018 68 Ward, PSYD Courtney 70 E 91ST STREET SUITE 210 Indianapolis, IN 46240-1564 1649529512 07/13/2016 07/12/2018 68 Westcott, PsyD Polly 703 Pro-Med Lane Carmel, IN 46032-5317 1649364985 05/08/2017 05/07/20 72 Cassaro,MD,Michael,G. 72 Kochert,MD,Carolyn,G 200 Missouri Avenue, Suite B Jeffersonville, IN 47130-3061 1457349722 03/01/2014 02/28/2018 3218 Daughtery Drive, Suite 110 Lafayette, IN 47909-3997 1306815915 10/01/2015 09/30/20 80 Batta,LCSW,Nichole,L 420 E Main Street Greenwood, IN 46143-1364 1366568776 07/29/2015 07/28/20 80 Child,LCSW,Jeffrey,F. 703 Pro Med Lane Carmel, IN 46032-5317 1669456471 01/01/2014 12/31/2017 80 Collins,MSW,Richard,A. 703 Pro-Med Lane Carmel, IN 46032-5317 1285013581 01/01/2016 12/31/2017 80 Dailey,LCSW,Jennifer,J 4214 Hobson Court Fort Wayne, IN 46815-8648 1548255821 10/01/2015 09/30/20 80 Falink,LCSW,Christina, 703 Pro Med Lane Carmel, IN. 46032-5317 92113252 01/01/2016 12/31/2017 80 Frantz, LCSW, Dana 703 Pro-Med Lane Carmel, IN 46032-5317 1780628958 07/15/2016 07/14/2018 80 Fogle, CSW Jessica 703 Pro-Med Lane Carmel, IN 46032-5317 1609935253 05/10/2017 05/09/20 80 Friesen,CSW,Rachel, 703 Pro-Med Lane Carmel, IN 46032-5317 1821072851 01/01/2016 12/31/2017 80 Glassburn- Larimer,LCSW,Susan,L. 703 Pro Med Lane Carmel, IN 46032-5317 1003161027 01/01/2014 12/31/2017 10/26/2017 www.wpsgha.com Page 18 of 21

80 George,CSW,Paul, 6284 Rucker Rd Ste N Indianapolis, IN 46220-4865 1093877094 02/09/2016 02/08/2018 80 Harber Porter,LCSW,Jeanne, 4214 Hobson Court Fort Wayne, IN 46815-8648 18182184 04/01/2015 03/31/20 80 Hartman,LCSW,Paul,N. 703 Pro Med Lane Carmel, IN 46032-5317 1710959226 01/01/2014 12/31/2017 80 Herrmann,LCSW,Micha el,f 11805 N Pennsylvania Street Carmel, IN 46032-4555 1356595730 10/01/2015 09/30/20 80 Hojnacki, LCSW, Jason 703 Pro-Med Lane Carmel, IN 46032-5317 1548472202 07/15/2016 07/14/2018 80 Hosier Ada, CSW 5660 Caito Dr Ste 122 Indianapolis, IN 46226-1364 1487611224 05/17/2016 05/16/2018 80 Jansen, Jennifer C. 703 Pro-Med Lane Carmel, IN 46032-5317 1164704888 09/12/2016 09/11/2018 80 Joray, LCSW Bruce 50550 Little John Lane Granger, IN 46530-7527 1679017834 04/01/2017 03/31/20 80 Lake,LCSW,Maryann, 703 Pro Med Lane Carmel, IN 46032-5317 1326383878 01/01/2014 12/31/2017 80 Lang, CSW Kathi 303 S Perry ST Attica, IN 47918-1441 1316165137 10/24/2016 10/24/2018 80 Leonard,LCSW,Erin,K 80 230 E Day Road, Suite 160 Mishawaka, IN 46545-3463 1770590986 08/06/2015 08/05/20 Moffett,LCSW,Kimberly, A. 703 Pro Med Lane Carmel, IN 46032-5317 82689568 01/01/2014 12/31/2017 80 Myers,LCSW,Kevin,N. 703 Pro Med Lane Carmel, IN 46032-5317 1487896304 01/01/2014 12/31/2017 80 Oser,LCSW,Jean,A 4214 Hobson Court Fort Wayne, IN 46815-8648 1063407286 10/01/2015 09/30/20 10/26/2017 www.wpsgha.com Page of 21

80 Roth, Mary, LCSW 703 Pro-Med Lane Carmel, IN 46032-5317 1669790580 07/15/2016 07/14/2018 80 Rubin,CSW,Sara, Schaefer 703 Pro-Med Lane Carmel, IN 46032-5318 1841352879 01/01/2016 12/31/2017 Robbins,LCSW,Carrie,L 80. 703 Pro Med Lane Carmel, IN 46032-5317 1225130321 01/01/2014 12/31/2017 80 Sharp,LCSW,Marlene, 6801 Lake Plaza Drive, Suite D 407 Indianapolis, IN 46220-4066 1831173517 05/20/2013 05//20 80 Shoot,LCSW,Carol,L. 703 Pro Med Lane Carmel, IN 46032-5317 1881678670 01/01/2014 12/31/2017 80 Strobel,LCSW,Amy,T 703 Pro Med Lane Carmel, IN. 46032-5317 15989706 01/01/2016 12/31/2017 80 Tyler, CSW Steven 703 Pro-Med Lane Carmel, IN 46032-5317 1689673824 11/10/2016 11/10/2018 80 Walter,LCSW,Evelyn,K. 703 Pro Med Lane Carmel, IN 46032-5317 1780656280 01/01/2014 12/31/2017 85 Burns,DDS,Christopher, A. 8170 Oaklandon Road, Suite B Indianapolis, IN 46236-9543 42283692 03/24/2014 03/23/2018 89 Whitaker,CNS,Kathleen, 209 W North St Lebanon, IN 46052-2121 1780838557 08//2015 08/17/20 93 Antoine,DO,Ellen, 40 North Rangeline Road Carmel, IN. 46032-1741 1700827029 03/06/2014 03/05/2018 97 Morris,PA-C,Ann,M 703 Pro Med Lane Carmel, IN. 46032-5317 14826842 01/01/2014 12/31/2017 97 Sheets, PA-C, Cassandra N. 2020 Union Street, Suite 300 Lafayette, IN 47904-2694 1497028088 07/01/2017 06/30/20 C5 Hadley,DDS,Thomas,L 210 W Harrison Street Monticello, IN 47960-2208 1437210705 06/01/2015 05/31/20 10/26/2017 www.wpsgha.com Page 20 of 21

C5 Miller, DMD, Abigale 505 Vistula Street Elkhart, IN 46516-2809 1366892382 10/12/2017 10/11/20 C5 Vail,DDS,Mychel, 10078 Lantern Road Fishers, IN. 46037-9685 1699898395 02/18/2016 02/17/2018 10/26/2017 www.wpsgha.com Page 21 of 21