NPIMap

Organization Active NPI

Digestive Specialists Inc

  • Gastroenterology Physician
  • Dayton, OH
National Provider Identifier
1174596563
Registry record updated Jun 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
DIGESTIVE SPECIALISTS INC
Practice address
4340 Clyo Rd Ste 200
Dayton, OH 45459-7000
Phone
(937) 534-7330
Fax
(937) 297-2203
NPI assigned
Feb 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2025

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

Authorized official

Name
Joan Servis
Title
Credentialing Specialist
Phone
(937) 396-2602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

4340 Clyo Rd Ste 200
Dayton, OH 45459-7000

Mailing address

4340 Clyo Rd Ste 200
Dayton, OH 45459-7000
Phone (937) 396-2602

Other practice location 1

77 W Eleanor Dr
Springboro, OH 45066-1615
Phone (937) 534-7330

Other practice location 2

5697 Shull Rd Ste 200
Huber Heights, OH 45424-1203
Phone (937) 534-7330

Other identifiers 1

IdentifierTypeStateIssuer
2248544MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040304001069 OH Part B Supplier - Clinic/Group Practice 2062300809 Receives reassigned benefits from 43 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Dayton, OH; Springboro, OH; Huber Heights, OH

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

5697 Shull Rd
Ste 200
Huber Heights, OH 45424

999 Brubaker Dr
Ste 1
Kettering, OH 45429
Phone (937) 350-6700

NPI Registry JSON

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750204800000",
    "number": "1174596563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4340 CLYO RD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597000",
            "telephone_number": "937-396-2602",
            "fax_number": "937-395-3682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4340 CLYO RD STE 200",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454597000",
            "telephone_number": "937-534-7330",
            "fax_number": "937-297-2203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 W Eleanor Dr",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450661615",
            "country_code": "US",
            "telephone_number": "937-534-7330",
            "fax_number": "937-297-2208",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5697 Shull Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241203",
            "country_code": "US",
            "telephone_number": "937-534-7330",
            "fax_number": "937-297-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIGESTIVE SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A",
        "authorized_official_last_name": "SERVIS",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "937-396-2602"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2248544",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; 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.