Organization Active NPI

Health Specialists of Dayton Inc

Doing business as Melissa P Roelle MD Company

  • Surgery Physician
  • Dayton, OH
National Provider Identifier
1437340825
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HEALTH SPECIALISTS OF DAYTON INC
Doing business as
Melissa P Roelle MD Company
Practice address
1 Elizabeth PL
Ste 10a
Dayton, OH 45408-1445
Phone
(937) 228-0248
Fax
(937) 228-0247
NPI assigned
Aug 9, 2007
Last updated
Jan 13, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTH SPECIALISTS OF DAYTON INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Authorized official

Name
Kenneth Prunier
Title
Ceo/President
Phone
(937) 208-8213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X Primary

Addresses

Primary practice location

1 Elizabeth PL
Ste 10a
Dayton, OH 45408-1445

Mailing address

1 Elizabeth PL
Ste 10a
Dayton, OH 45408-1445
Phone (937) 228-0248

Other identifiers 1

IdentifierTypeStateIssuer
2764512MedicaidOH

Other names 1

  • Melissa P Roelle MD Company Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000010 OH Part B Supplier - Clinic/Group Practice 5597708594 Receives reassigned benefits from 938 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Premierhealth

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1437340825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "address_2": "STE 10A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454081445",
            "telephone_number": "937-228-0248",
            "fax_number": "937-228-0247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ELIZABETH PL",
            "address_2": "STE 10A",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454081445",
            "telephone_number": "937-228-0248",
            "fax_number": "937-228-0247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SPECIALISTS OF DAYTON INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTH SPECIALISTS OF DAYTON INC",
        "enumeration_date": "2007-08-09",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "PRUNIER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "937-208-8213"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2764512",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Melissa P Roelle MD Company",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 13, 2009; 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.