Dayton Children's Orthopaedic Center for Spinal & Pediatric Care, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

050826 Issued in OH

Legal business name

DAYTON CHILDREN'S ORTHOPAEDIC CENTER FOR SPINAL & PEDIATRIC CARE, LLC

Practice address

1 Childrens PLZ
Dayton, OH 45404

Phone

(937) 641-3010

Fax

(937) 641-5003

NPI assigned

May 23, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lisa Coffey

Title

President

Phone

(937) 641-3610

Specialties & licenses 1

Addresses

Other identifiers 10

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Dayton Children's Specialty Physicians, Inc.

  • Pediatrics Physician
  • Dayton, OH
  • NPI 1780467555

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Stanley Marhelski, PAC

  • Physician Assistant
  • Dayton, OH
  • NPI 1982855060
  NPD (past)
• Beryl Ann Smith, P.T.

  • Orthopedic Physical Therapist
  • Dayton, OH
  • NPI 1558332122
  NPD (past)
• Nicolas Enrique Grisoni, MD

  • Orthopaedic Surgery of the Spine Physician
  • Phoenix, AZ
  • NPI 1104959220
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1124021324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454041898",
            "telephone_number": "937-641-3010",
            "fax_number": "937-641-5003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PLZ",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45404",
            "telephone_number": "937-641-3010",
            "fax_number": "937-641-5003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 S Stanfield Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453732334",
            "country_code": "US",
            "telephone_number": "937-641-3010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Blvd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420817",
            "country_code": "US",
            "telephone_number": "937-641-3010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DAYTON CHILDREN'S ORTHOPAEDIC CENTER FOR SPINAL & PEDIATRIC CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "COFFEY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "937-641-3610",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "050826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0060237",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY PASSPORT",
            "identifier": "65901415",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65901415",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200251960A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUREAU OF WORKERS COMP",
            "identifier": "2125835800",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155448",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "914700400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "CG2790",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG2790",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2252233",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dayton Children's Hospital
• Dayton Children's Hospital
• Dayton Children's Hospital (Dayton Children's Hospital Outpatient Pharmacy)
• Dayton Children's Hospital
• Dayton Children's Medical Center
• Dayton Children's Specialty Physicians, Inc.
• Dayton Children's Specialty Physicians, Inc.
• Dayton Children's Specialty Physicians, Inc. (Dayton Children's Specialty Physicians Inc. (Optical Retail Shop))
• Dayton Childrens Cardiology Inc
• Dayton Childrens Dental Center, LLC

• Specialist in Dayton, OH
• Providers in Dayton, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.