NPIMap

Organization Active NPI

Southwest Ohio ENT Specialists Inc

  • Otolaryngology Physician
  • Dayton, OH
National Provider Identifier
1255301560
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
SOUTHWEST OHIO ENT SPECIALISTS INC
Practice address
1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone
(937) 496-2600
Fax
(937) 496-2610
NPI assigned
Jan 26, 2006
Last updated
Jan 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Authorized official

Name
Mr. Daniel E Young
Title
Business Manager
Phone
(937) 496-2620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684

Mailing address

1222 S Patterson Blvd
Suite 400
Dayton, OH 45402-2684
Phone (937) 496-2600

Other identifiers 1

IdentifierTypeStateIssuer
0804697MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526001634 OH Part B Supplier - Clinic/Group Practice 2163403098 Receives reassigned benefits from 52 practitioners
Practice locations: Dayton, OH

National Provider Directory

National Provider Directory

Locations

1 Childrens Plz
Lowr
Dayton, OH 45404

1222 S Patterson Blvd
Ste 400
Dayton, OH 45402
Phone (937) 496-2600

369 W 1st St
#400
Dayton, OH 45402
Phone (937) 496-2600

9000 N Main St
Ste 320
Englewood, OH 45415
Phone (937) 496-2600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD

Practitioners & affiliated clinicians

Practitioners 68

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.

View all 68

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358121600000",
    "number": "1255301560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE 400",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-496-2600",
            "fax_number": "937-496-2610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST OHIO ENT SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2013-01-14",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "937-496-2620",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0804697",
            "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 Jan 14, 2013; 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.