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SHILOH FAMILY MEDICINE LLC
NPI 1255526471
Family Medicine in Dayton, OH

Active since September 11, 2007CLIA 36D1006900 · Waiver
5900 N MAIN ST STE 3, DAYTON, OH 45415(937) 277-9371 Get Directions Write a Review

NPPES record last updated: January 3, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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

NPI1255526471
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSHILOH FAMILY MEDICINE LLC
Location Address5900 N MAIN ST STE 3Dayton, OH 45415-3198
Mailing Address5900 N Main St Ste 3Dayton, OH 45415-3198 · (937) 277-9371
Phone(937) 277-9371
Organization SubpartNo
Authorized OfficialEdward ClackPhysician · (937) 277-9371
Enumeration DateSeptember 11, 2007
Last NPPES UpdateJanuary 3, 2023
NPPES CertifiedJanuary 3, 2023
✔ NPI 1255526471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5900 N MAIN ST STE 3, Dayton, OH 45415
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Other Identifiers 2

Other000000236927Anthem
Medicaid2353911OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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, OH
Active · expires Dec 3, 2026
CLIA Number36D1006900
Laboratory TypePhysician Office
Certificate Effective DateDecember 4, 2024
Certificate Expiration DateDecember 3, 2026
Laboratory DirectorEdward P. Clack
Laboratory Phone(930) 277-9371
Laboratory LocationShiloh Family Medicine5900 N Main Street, Suite 3, Dayton, OH 45415
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EDWARD PETERSEN CLACK DO
Family Medicine
5900 N MAIN ST STE 3
DAYTON, OH 45415
Montgomery County (937) 277-9371
SHANNON R BAKER
Counselor (Professional)
5900 N MAIN ST STE 3
DAYTON, OH 45415
Montgomery County (937) 277-9371
BAC MEDICAL LLC
Family Medicine
5900 N MAIN ST STE 3
DAYTON, OH 45415
Montgomery County (937) 277-9371

Frequently 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.

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 Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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 with the weekly NPPES data releases published by CMS.