Organization Active NPI

Health Specialists of Dayton Inc

  • Surgical Oncology Physician
  • Springboro, OH
National Provider Identifier
1124208574
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
Legal business name
HEALTH SPECIALISTS OF DAYTON INC
Doing business as
Samira Y Khera MD Company
Practice address
5 Sycamore Creek Dr
Springboro, OH 45066-2300
Phone
(937) 748-4211
Fax
(937) 748-3566
NPI assigned
Nov 13, 2007
Organization subpart
Yes
Parent organization
HEALTH SPECIALISTS OF DAYTON INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Kenneth Prunier
Title
President/Ceo
Phone
(937) 208-8213

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X
Surgical Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086X0206X Primary

Addresses

Primary practice location

5 Sycamore Creek Dr
Springboro, OH 45066-2300

Mailing address

5 Sycamore Creek Dr
Springboro, OH 45066-2300
Phone (937) 748-4211

Other names 1

  • Samira Y Khera MD Company Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000010 OH Part B Supplier - Clinic/Group Practice 5597708594 Receives reassigned benefits from 938 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Premier Health Specialist Inc

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1124208574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SYCAMORE CREEK DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450662300",
            "telephone_number": "937-748-4211",
            "fax_number": "937-748-3566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SYCAMORE CREEK DR",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450662300",
            "telephone_number": "937-748-4211",
            "fax_number": "937-748-3566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SPECIALISTS OF DAYTON INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH SPECIALISTS OF DAYTON INC",
        "enumeration_date": "2007-11-13",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "937-208-8213"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgical Oncology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Samira Y Khera MD Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.