Digestive Health Specialists, PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DIGESTIVE HEALTH SPECIALISTS, PA

Practice address

280 Broad St
Suite F
Kernersville, NC 27284-2796

Phone

(336) 768-6211

Fax

(336) 768-6869

NPI assigned

Oct 5, 2012

Last updated

May 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jacquelyn Tillinger, MHA

Title

Ceo

Phone

(336) 768-6211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

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

• Digestive Health Specialists, PA

  • Ambulatory Surgical Clinic/Center
  • Winston Salem, NC
  • NPI 1306005343

  O20070922000071

  Same enrollment
• Digestive Health Specialists, PA

  • Ambulatory Surgical Clinic/Center
  • Thomasville, NC
  • NPI 1487090452

  O20070922000071

  Same enrollment

Listed as

Digestive Health Specialists PACCN 34C0001142

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Digestive Health Specialists PACCN 34C0001185

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tilak Raj Baba

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1093058307
  NPD
• Stacey Jefferson Coats, NP

  • Nurse Practitioner
  • Winston Salem, NC
  • NPI 1548934847
  NPD
• Jeremy Thomas Gillespie, M.D.

  • Internal Medicine Physician
  • Winston Salem, NC
  • NPI 1407146319
  NPD
• Austin Clay Pope, PA

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1518630581
  NPD
• Neal Sharma, MD

  • Gastroenterology Physician
  • Winston Salem, NC
  • NPI 1902225535
  NPD

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1184976797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FRONTIS PLAZA BLVD",
            "address_2": "SUITE 200",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271035663",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST",
            "address_2": "SUITE F",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842796",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "TILLINGER",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-768-6211",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Elaine Devries
• Andrea Lynn Dew, M. A., CCC-SLP
• Diagnostic Radiology & Imaging, LLC (Greensboro Imaging at Kernersville)
• Deborah Diamond-Tubby
• Cathy Dickerson
• Digestive Health Specialists, PA
• Brianna Diggs
• Claire Sanger Dillingham, D.O.
• Jeryl Eric Dillow, L.A.T., A.T.C.
• Distinguished Senior Services

• Ambulatory Surgical Clinic/Center in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Ambulatory Surgical Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.