NPIMap

Organization Active NPI

Pulmonary & Critical Care Consultants, Inc

  • Pulmonary Disease Physician
  • Dayton, OH
National Provider Identifier
1861432379
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
PULMONARY & CRITICAL CARE CONSULTANTS, INC
Practice address
1520 S Main St Ste 2
Dayton, OH 45409-2643
Phone
(937) 461-5815
Fax
(937) 461-2896
NPI assigned
Jun 7, 2006
Last updated
Jun 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Shaunna Holbert
Title
Operations Manager
Phone
(937) 461-2057

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
Pulmonary Disease Physician 207RP1001X Primary
Sleep Medicine (Internal Medicine) Physician 207RS0012X

Addresses

Primary practice location

1520 S Main St Ste 2
Dayton, OH 45409-2643

Mailing address

1520 S Main St
#2
Dayton, OH 45409-2698
Phone (937) 461-5815

Other identifiers 1

IdentifierTypeStateIssuer
0562707MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040628001629 OH Part B Supplier - Clinic/Group Practice 9234115379 Receives reassigned benefits from 42 practitioners
Practice locations: Dayton, OH; Troy, OH

National Provider Directory

National Provider Directory

Locations

2300 Miami Valley Dr
Ste 370
Dayton, OH 45459
Phone (937) 461-5815

6611 Clyo Rd
Dayton, OH 45459
Phone (937) 208-8282

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1861432379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 S MAIN ST",
            "address_2": "#2",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092698",
            "telephone_number": "937-461-5815",
            "fax_number": "937-461-2896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S MAIN ST STE 2",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092643",
            "telephone_number": "937-461-5815",
            "fax_number": "937-461-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULMONARY & CRITICAL CARE CONSULTANTS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "HOLBERT",
        "authorized_official_first_name": "SHAUNNA",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "937-461-2057"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0562707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 18, 2024; 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.