Digestive Health Specialists, PA

Organization Active NPI Gastroenterology Physician · King, NC

NPI 1275930968 · NPPES record last updated Apr 4, 2017

Key facts

NPI
1275930968
Entity type
Organization (NPI type 2)
Primary specialty
Gastroenterology Physician 207RG0100X
Legal business name
DIGESTIVE HEALTH SPECIALISTS, PA
Practice address
434 Kirby Rd
Lower Level Suite 6
King, NC 27021-9494
Phone
(336) 768-6211
Fax
(336) 768-6869
NPI assigned
Nov 25, 2014
Organization subpart
No

Authorized official

Name
Mrs. Jacquline Tillinger, MHA
Title
Ceo
Phone
(336) 768-6211

Other NPIs on the same Medicare enrollment 5

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

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NC

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040610000265 NC Part B Supplier - Clinic/Group Practice 6507849601 Receives reassigned benefits from 28 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Thomasville, NC; Winston Salem, NC; King, NC; Advance, NC; Kernersville, NC

National Provider Directory

Tax ID family
Digestive Health Specialists PA (3 organizations share this tax ID)

Locations

434 Kirby Rd
Lowr
King, NC 27021

434 Kirby Rd
King, NC 27021

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207RG0100X Yes

Addresses

Primary practice location

434 Kirby Rd
Lower Level Suite 6
King, NC 27021-9494

Mailing address

2025 Frontis Plaza Blvd
Suite 200
Winston Salem, NC 27103-5663
Phone (336) 768-6211

Other providers in King, NC

All providers in King, NC · Gastroenterology Physician in North Carolina

Sources for this page

Verify at the official NPI Registry.