Digestive Health Specialists, PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

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

May 4, 2009

Last updated

Apr 4, 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

Mrs. Jacquelyn Tillinger, MHA

Title

Ceo

Phone

(336) 768-6211

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

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

• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Advance, NC
  • NPI 1073745485

  O20040610000265

  Same enrollment
• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • King, NC
  • NPI 1275930968

  O20040610000265

  Same enrollment
• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Greensboro, NC
  • NPI 1497209613

  O20040610000265

  Same enrollment
• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Winston Salem, NC
  • NPI 1801837745

  O20040610000265

  Same enrollment
• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Thomasville, NC
  • NPI 1841474384

  O20040610000265

  Same enrollment

Tax ID family

Forsyth Gastroenterolog3 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.

• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • King, NC
  • NPI 1275930968
  NPD tax ID
• Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Thomasville, NC
  • NPI 1841474384
  NPD tax ID

Practitioners 3

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.

• William Charles Bray, MD

  • Gastroenterology Physician
  • Winston Salem, NC
  • NPI 1952345951
  NPD
• Elizabeth Leigh Greenwood, PA-C

  • Medical Physician Assistant
  • Winston Salem, NC
  • NPI 1619381753
  NPD
• Meredith M. Williams, PA

  • Physician Assistant
  • Winston Salem, NC
  • NPI 1649534629
  NPD

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1346474566",
    "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": "2009-05-04",
        "last_updated": "2017-04-04",
        "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_name_prefix": "Mrs.",
        "authorized_official_credential": "MHA"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "34D1086999",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 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
• Taylor Doktycz

• Gastroenterology Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Gastroenterology Physician in North Carolina

• 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.