NPIMap

Organization Active NPI

Digestive Health Specialists, PA

  • Gastroenterology Physician
  • Winston Salem, NC
National Provider Identifier
1801837745
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
40100 Issued in NC
Legal business name
DIGESTIVE HEALTH SPECIALISTS, PA
Practice address
2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663
Phone
(336) 768-6211
Fax
(336) 768-6869
NPI assigned
Jun 10, 2006
Last updated
May 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Authorized official

Name
Jacquelyn Tillinger
Title
Ceo
Phone
(336) 768-6211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 40100 NC Primary

Addresses

Primary practice location

2025 Frontis Plaza Blvd
Suite 200
Winston-Salem, NC 27103-5663

Mailing address

2025 Frontis Plaza Blvd Ste 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
Practice locations: Thomasville, NC; Winston Salem, NC; King, NC; Advance, NC; Kernersville, NC

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Locations

137 Mount Calvary Rd
Thomasville, NC 27360

2025 Frontis Plaza Blvd
Ste 210
Winston Salem, NC 27103
Phone (336) 768-3671

37 N 5th St
#39
Gettysburg, PA 17325

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494979200000",
    "number": "1801837745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 FRONTIS PLAZA BLVD STE 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": "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE HEALTH SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-10",
        "last_updated": "2017-05-17",
        "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"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "40100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.