Endoscopy Center of Dayton North LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0619AS Issued in OH

Legal business name

ENDOSCOPY CENTER OF DAYTON NORTH LLC

Practice address

9000 N Main St
Suite 405
Dayton, OH 45415-1180

Phone

(937) 320-5050

Fax

(937) 320-5060

NPI assigned

Jul 18, 2005

Last updated

Sep 17, 2024By 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

Christopher Hartshorn

Title

Officer/Authorized Official

Phone

(314) 800-2017

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Endoscopy Center of Dayton North LLCCCN 36C0001148

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

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

• Dayton Gastroenterology LLC

  dba Digestive Disease Consultants

  • Gastroenterology Physician
  • Dayton, OH
  • NPI 1134345705

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

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.

• Gregory J Beck, M.D.

  • Gastroenterology Physician
  • Dayton, OH
  • NPI 1508831991
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1194724690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SYLVANIA DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454403237",
            "telephone_number": "937-320-5050",
            "fax_number": "937-320-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 405",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-320-5050",
            "fax_number": "937-320-5060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER OF DAYTON NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "HARTSHORN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "314-800-2017"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0619AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2218504",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Encompass Health Rehabilitation Hospital of Dayton, LLC (The Rehabilitation Institute of Ohio, a Joint Venture between Premier)
• Endless Hope Home Care LLC
• Endodontics South, Inc.
• Elizabeth Eng
• Melanie Engber
• Richard Engelken
• Deanna England
• Brenda McDonald Engle, CST/CFA

• Ambulatory Surgical Clinic/Center in Dayton, OH
• Providers in Dayton, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.