Digestive Endoscopy Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DIGESTIVE ENDOSCOPY CENTER LLC

Practice address

5697 Shull Rd Ste 100
Huber Heights, OH 45424-1203

Phone

(937) 534-7330

Fax

(937) 297-2208

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey E. Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Digestive Endoscopy Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Digestive Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Dayton, OH
  • NPI 1003888710

  O20081030000063

  Same enrollment
• Digestive Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Springboro, OH
  • NPI 1144416587

  O20081030000063

  Same enrollment
• Digestive Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Dayton, OH
  • NPI 1194790808

  O20081030000063

  Same enrollment

Listed as

Digestive Endoscopy Center LLCCCN 36C0001164

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Digestive Endoscopy Center LLC3 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 Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Dayton, OH
  • NPI 1003888710
  NPD tax ID
• Digestive Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Springboro, OH
  • NPI 1144416587
  NPD tax ID

Locations

Practitioners 1

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

• Chiyoko Rando, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1073353728
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652140800000",
    "number": "1497727119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-240-3720",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5697 SHULL RD STE 100",
            "city": "HUBER HEIGHTS",
            "state": "OH",
            "postal_code": "454241203",
            "telephone_number": "937-534-7330",
            "fax_number": "937-297-2208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5697 Shull Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241203",
            "country_code": "US",
            "telephone_number": "937-534-7330",
            "fax_number": "937-297-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DIGESTIVE ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017856",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1211AS",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Digestive Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Digestive Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Suevenia S Dewberry
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• Divine Help Home Health Care
• Jasmine Dixon
• Krystal Dixon, CPHT

• Ambulatory Surgical Clinic/Center in Huber Heights, OH
• Providers in Huber Heights, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.