SHILOH FAMILY MEDICINE LLC
NPI 1255526471
Family Medicine in Dayton, OH
About Shiloh Family Medicine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SHILOH FAMILY MEDICINE LLC (NPI 1255526471) is a healthcare organization registered as a family medicine in Dayton, Ohio and active in the NPI registry since September 2007. The organization holds a CLIA Waiver certificate valid through December 3, 2026 and lists Edward Clack, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Shiloh Family Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Shiloh Family Medicine LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 36D1006900
Shiloh Family Medicine · Dayton, OHFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Shiloh Family Medicine LLC's NPI number?
The NPI number for Shiloh Family Medicine LLC is 1255526471. It was assigned to this organization in the NPPES registry on September 11, 2007.
Where is Shiloh Family Medicine LLC located?
Shiloh Family Medicine LLC is located at 5900 N Main St Ste 3, Dayton, OH 45415. The listed phone number is (937) 277-9371.
What is Shiloh Family Medicine LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Shiloh Family Medicine LLC enrolled in Medicare?
Yes. Shiloh Family Medicine LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Shiloh Family Medicine LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Shiloh Family Medicine LLC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Shiloh Family Medicine LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 36D1006900) is associated with this NPI, valid through December 3, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Shiloh Family Medicine LLC accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource and Molina Healthcare list Shiloh Family Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Shiloh Family Medicine LLC was last updated on January 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Shiloh Family Medicine Llc · NPI 1255526471
Family Medicine organization in Dayton, Ohio. Organization record, active in the CMS NPPES registry since September 11, 2007.
## Identity
- **NPI:** 1255526471 (Entity type: Organization)
- **Enumerated:** September 11, 2007
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Edward Clack, PHYSICIAN
## Practice location
- **Address:** 5900 N MAIN ST STE 3, Dayton, OH 45415-3198
- **Phone:** (937) 277-9371
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Family Practice (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 3, 2023
- **Other identifiers:** Other 000000236927; Medicaid 2353911 (OH)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1255526471) · Data from the CMS NPPES public registry.