Active NPI
Health Specialists of Dayton Inc
- Obstetrics & Gynecology Physician
- Dayton, OH
National Provider Identifier
1639124175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- HEALTH SPECIALISTS OF DAYTON INC
- Practice address
- 160 Wyoming St
Dayton, OH 45409-2740 - Phone
- (937) 224-8890
- Fax
- (937) 224-0140
- NPI assigned
- May 23, 2006
- Organization subpart
- Yes
- Parent organization
- HEALTH SPECIALISTS OF DAYTON INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary |
Addresses
Primary practice location
160 Wyoming St
Dayton, OH 45409-2740
Mailing address
160 Wyoming St
Dayton, OH 45409-2740
Phone (937) 224-8890
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2585135 | Medicaid | OH |
Other names 1
- Nam X. Nguyen MD Co
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Premier Health Specialist Inc
Locations
160 Wyoming St
Dayton, OH 45409
Phone (937) 208-6137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1273017600000",
"number": "1639124175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092740",
"telephone_number": "937-224-8890",
"fax_number": "937-224-0140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 WYOMING ST",
"city": "DAYTON",
"state": "OH",
"postal_code": "454092740",
"telephone_number": "937-224-8890",
"fax_number": "937-224-0140"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTH SPECIALISTS OF DAYTON INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "HEALTH SPECIALISTS OF DAYTON INC",
"enumeration_date": "2006-05-23",
"last_updated": "2010-05-05",
"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": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2585135",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Nam X. Nguyen MD Co",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Dayton, OH
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- Health Specialists of Dayton Inc
- Health Wise Integrated Health Care Inc
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2010; 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.