NPIMap

Organization Active NPI

Digestive Health Specialists, PA

  • Gastroenterology Physician
  • King, NC
National Provider Identifier
1275930968
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 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
Last updated
Apr 4, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X Primary

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

Medicare participation

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

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Ultrasound Assoc LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

434 Kirby Rd
Lowr
King, NC 27021

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1275930968",
    "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": "434 KIRBY RD",
            "address_2": "LOWER LEVEL SUITE 6",
            "city": "KING",
            "state": "NC",
            "postal_code": "270219494",
            "telephone_number": "336-768-6211",
            "fax_number": "336-768-6869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "TILLINGER",
        "authorized_official_first_name": "JACQULINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "336-768-6211",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.